By Clennkei C. Peรฑalosa
ZAMBOANGA CITY, Sept 5 (PIA) – In response to the ongoing challenge to our country's health system, Philippine Health Insurance Corporation (PhilHealth) sets maximum hemodialysis benefit package up to 144 sessions for the year 2022 through PhilHealth Board Resolution No. 2718 s. 2022.
Philhealth-9 Benefit Administration Section Head, Dr. Jacob Maria D.V. Mendoza said the purpose of this Circular is to present the recommendations for outpatient hemodialysis that sets the maximum limit of hemodialysis up to 144 sessions for the year 2022.
Before the resolution, only 90 sessions are covered in the hemodialysis benefit package but due to COVID-19 pandemic in 2020, PhilHealth increased its yearly hemodialysis coverage to 144 sessions which costs Php2,600 per session.
He stressed this policy covers all PhilHealth members and their usual dependents with chronic kidney disease stage 5 (CKD5) who are currently enrolled in the PhilHealth Dialysis Database (PDD). This policy states the payment of more than 90 to 144 hemodialysis sessions until December 31, 2022.
Dr. Mendoza clarified if a patient with CKD5 is hospitalized and needs dialysis, they cannot use this benefit because this policy is exclusively set for outpatient hemodialysis sessions only.
Moreover, if the patient with CKD5 does not use the 91st - 144th hemodialysis sessions, it cannot be used or added to the year 2023 because the scope of this policy is only until December 31, 2022.
This year’s policy on increased coverage for hemodialysis outpatients was release in the month of August, however, if a member or patient already paid the 91st – 144th hemodialysis sessions, they can directly file it to the nearest PhilHealth Regional or Branch Office or Local Health Insurance Office and follow the existing criteria based on PhilHealth Circular No. 20 s. 2014 (ACR Policy No. 4 - Directly Filed Claims for All Case Rates and Return to Sender). (EDT/MLE/CCP/PIA9-Zamboanga City)
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