PhilHealth accreditation
I heard many dialysis centers, as well as large, well-known hospitals, were recently not accredited by PhilHealth. "Denied" was the letter they received. No explanation as to the reason for the denial. What this means is those not accredited by PhilHealth can no longer accept patients who use their PhilHealth benefits for dialysis treatments. Non-accredited centers or hospitals cannot process documents for them to be paid by the state insurer. According to current law, a PhilHealth member is entitled to 90 dialysis sessions in one year. Any treatment that goes beyond that is shouldered by the patient unless he finds help from PCSO or politicians. The 90 sessions are a lifeline, more so when the Universal Health Care becomes law, where those dialysis sessions are bumped up to 120. That should already cover a full year.
But this is a new year. Another ninety sessions should be available but unfortunately, PhilHealth has not accredited a lot of centers. Members are now looking for accredited centers but I doubt if they can accommodate everyone. I really do not know the criteria or reason for being denied if even well-known hospitals are not spared. This is definitely not how the year should start for the patients.
What happened to PhilHealth? Is it running out of money? Wasn't there an increase in member contributions because of the Universal Health Care Law? Does it have to do with the alleged scam done by a dialysis center where deceased patients were still undergoing dialysis? Where it was exposed that deceased patients were still collecting for PhilHealth? Hopefully, PhilHealth will properly and fairly investigate dialysis centers whether they should be accredited. Many patients rely on PhilHealth, which is why they become members in the first place. Some dialysis centers may not handle a large number of patients who cannot be served by those who are not currently accredited.
I know it's not easy to ask for financial help from politicians because of the unconstitutionality of the "Pork Barrel" which has undergone many names. It is also difficult to seek financial help from the PCSO because of the sheer number of the very poor asking for help. It all boils down to PhilHealth. Dialysis patients need their centers back online. A patient with end-stage renal disease may survive several weeks without dialysis, but getting the overhydration out of the patient is crucial. ESRD patients could literally drown or congest. So whatever is bugging PhilHealth, I hope they sort things out very soon.
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