Mindanaotoda.com | PhilHealth ups dialysis deal, urges members to join Konsulta
By: Jan Albert K. Araña
MISAMIS ORIENTAL – The Philippine Health Insurance Corporation (PhilHealth)-10 ups the hemodialysis benefit package to one hundred fifty-two sessions as the insurance provider released its new circular.
Members undergoing hemodialysis can now take advantage of expanded benefits under PhilHealth Circular No. 2023-009, with PhilHealth increasing its hemodialysis sessions to 156 per year from its previous package of 90 sessions.
“May separate 45 days benefit allowance ang ating dialysis patients iba pa po ito156 session exclusive para sa kanilang pagpapadialysis. So kahit na po mag three times a week dialysis so ang sagot po ng Philhealth P2,600 times 156 so sa loob ng isang taon sumatotal na P405,600 ang tulong pinansiya,” PhilHealth-10 Vice President Delio A. Aseron said
(Our dialysis patients have a separate 45-day benefit allowance. It is different from the 156 sessions exclusive for their dialysis. So even if they have a dialysis session three times a week, PhilHealth answers for the payment of P2,600. So if we multiply it by 156, a total of P405,600 financial assistance is given in a year).
Aseron reported that as of 2023, PhilHealth paid P505,142,615.48 claims to the accredited hospital and free-standing dialysis clinic, making hemodialysis the top case in the region.
Moreover, based on the package rate, P2,600 is divided between the hospital facility fee amounting to P2,250, and P350 for the Professional fee. It also states that if a Chronic Kidney Disease Stage 5 (CKD5) patient on hemodialysis (HD) needs hospital confinement, the HD sessions shall be filed separately and should not overlap with the inpatient claim. It also emphasized that unused treatment sessions for the current year will not be carried over to the succeeding years.
ON KONSULTA
Meanwhile, PhilHealth-10 continues to encourage its members to register for the Konsultang Sulit at Tama (Konsulta) program, wherein registered members may avail of 13 selected laboratory and diagnostic examinations in their partner Konsulta providers such as CBC with platelet count, urinalysis, fecalysis, sputum microscopy, fecal occult blood, pap smear, lipid profile, FBS, OGTT, ECG, chest x-ray, creatinine, and HbA1c.
“Ito po ang primary health care benefit kung saan bawat membro ay iaasign sa pinakamalapit na primary care facility or Konsulta Facility be it LGU or government owned facility, health center o kaya naman po mga private facility na nagpaaccredit sa amin,” Aseron said
(This benefit offers primary healthcare services, allowing a member to be designated to the nearest primary care facility or Konsulta facility. This can include LGU or government-owned health centers, as well as private facilities accredited with us.)
Aside from the services, Konsulta members can avail of the selected drugs and medicines for anti-microbial, fluid and electrolytes, anti-asthma, antipyretic, anti-diabetic, anti-dyslipidemia, anti-hypertensive, anti-thrombotic, and anti-histamine.
Currently, PhilHealth has 106 accredited Konsulta providers, 283 accredited outpatient facilities like CIU, COVID-19 test labs, Konsulta PCB, and TB Dots; 127 accredited level 1-3 infirmaries, hospitals and dialysis clinics; and 2,135accredited health care professionals in the region.
PhilHealth encourages those who are not yet members to register themselves to avail of the benefit packages; while members are urged to sign up for the Konsulta benefit packages. The agency also reminds those members who are, or have beneficiaries undergoing hemodialysis, to register with the PhilHealth Dialysis Database to avail of the extended hemodialysis package. (JAKA/PIA10)
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