HEMODIALYSIS treatment remains the highest reimbursed benefit by the Philippine Health Corporation (PhilHealth) Regional Office 6 over the past three years. This follows the expansion of covered dialysis sessions from 90 to 156 sessions per year.

From June 2023 to June 2025, PhilHealth has paid a total of P4.12 billion for 814,973 dialysis claims across Western Visayas. Of these, 46.92% were from patients in Negros Occidental while 34.81% came from Capiz.

Patients diagnosed with chronic kidney disease (CKD) stage 5 are entitled to P6,350 per hemodialysis session, with a maximum benefit of P990,600.00 annually for up to 156 sessions. The package covers drugs and medicines, laboratory tests, medical supplies, administrative and professional fees.

Lazaro T. Tabsing, PhilHealth acting regional head, urged all accredited dialysis facilities to submit complete and error-free claims to avoid payment delays or denials.

“PhilHealth processes and pays valid claims within 25 days. However, some claims are returned due to discrepancies or lacking/incomplete documents,” Tabsing said. “Claims filed beyond the prescribed period or involving patients not registered in the PhilHealth Dialysis Database (PDD) are also subject to denial.”

Tabsing also emphasized the importance of preventive care, encouraging members to maximize their benefits under the PhilHealth Yaman ng Kalusugan Program (YAKAP). The expanded primary care package covers services including consultations, health screenings, diagnostic tests (including cancer screenings), and provision of outpatient medicines as prescribed by the YAKAP physician.

“While PhilHealth continues to support patients undergoing hemodialysis, it is equally important to focus on early detection and prevention to reduce the burden of chronic illnesses,” Tabsing added.

To date, 212 YAKAP facilities are accredited across Region 6, bringing primary care closer to communities./WDJ