A PhilHealth official on Saturday said the agency is open to talk with Dialysis Coalition of the Philippines Inc. (DCPI) to further look into their concerns about the no-balance billing system.
In a Viber message to DAILY TRIBUNE, PhilHealth Acting Vice President Rey Tomas Balena said PhilHealth will hold a dialogue with DCPI on the third week of July.
This, after the DCPI expressed concerns about PhilHealth Circular 2024-0014 which sets the reimbursement rate for each session at P4,000 and prohibits additional charges to patients under the “No Balance Billing” system.
The DCPI argued that the P4,000 rate doesn’t cover all the expenses associated with hemodialysis (HD) treatment, including essential medications and tests. They initially proposed a rate of P5,200.
Balena, however, clarified that they consulted their providers and even used data from them to see the cost of essential services due HD patients.
“These have been the basis in the determination of the package rate of P4,000,” Balena said.
The PhilHealth official explained that the items added into the standard services covered are not required for every session.
The provision of which will depend on need or as prescribed by the physician, Balena added.
“It will still be the physician who determines the need, not the patient. So even if the patient will demand, it is the physicians who will still decide if needed,” he furthered.
“For example labs, these are only done once a month (not every session). Then, the epoetin will depend on prescription. There may be instances that these are needed and they may exceed the P4,000 package, but in the rest of the sessions that will not require these, their cost is below the package rate.”