YOUR PHILHEALTH BENEFITS
The following conditions must be met in order to avail your PhilHealth benefits:
- Availment must be within the validity period as stated in Member Data Record (MDR) or in your payment receipt.
- The 45 days allowance for room and board of the member and the separate 45 days allowance shared among the dependents have not yet been consumed.
- Benefit availment procedures for outright deduction of benefits
a. Duly accomplished Claim Signature Form (CSF) -- original,
b. Official Receipt of applicable premium payment upon admission and Member Data Record (MDR).
c. If qualified dependent is not listed in the MDR -- submit applicable proof of dependency:
A. For parents 60 yrs. old and above
- Birth certificate of member with registry number
- Senior Citizen ID (photocopy)
- PhilHealth Member Registration Form (PMRF)
B. For children below 21 years old
- Birth certificate of child with registry number
- Discharge Slip from Nurses Station for our basis case rate deduction
- Operative Technique, Anesthesia Record and Delivery Record for surgical procedures.
- Upon submission of all applicable documents, the billing section will compute
and deduct the benefits from the total hospital bill.
G/F Main Hospital Building
889-DLSMC (35762) ext. 3352
PHILHEALTH Z BENEFIT PACKAGE
De Los Santos Medical Center offers the Z-benefit Package for Kidney TransplantationCriteria:
- Signed Member Empowerment (ME) Form;
- Age ›10 and ‹70 years;
- Single organ transplant;
- Patient on chronic dialysis because of end stage renal disease or patient for pre-emptive kidney transplantation with the following:
been progressive over the previous 6 – 12 months
- The recipient’s measured (nuclear scan) glomerular filtration rate, 24-hour urine creatinine clearance
or calculated glomerular filtration rate should be less than 20 ml/min/1.73m2 in diabetics or less
than 15 ml/min / 1.73m2 in patients with non-diabetic renal disease
5. Low immunologic risk defined as:- Past Panel Reactive Antibody (PRA) less than or equal to 20%
- Primary kidney transplant (no previous solid organ transplant)
- No donor specific antibody (DSA) in the potential recipient
- At least 1 HLA-DR match
- Potential recipient has no previous history of cancer (except basal cell skin cancer), should be HIV negative, Hepatitis B surface antigen negative, and Hepatitis C antibody negative
- Transplant candidate who is CMV-negative cannot receive an organ from a CMV-positive donor.
- Absence of current severe illness (Congestive heart failure Class 3-4, liver cirrhosis (findings of small liver with coarse granular/heterogenous echo pattern with signs of portal hypertension), chronic lung disease requiring oxygen, etc.)
- Absence of the following: hemi-paralysis because of stroke, leg amputation because of peripheral vascular disease or diabetes, mental retardation such that informed consent cannot be made, and substance abuse for at least 6 months prior to start of transplant work-up.
- Eligible patient for kidney transplant must have a certification from the social service of the hospital that they can maintain anti-rejection medicines for the next three (3) years.
Kidney Transplant Office
3/F Main Hospital Building
889-DLSMC (35762) ext. 7158