YOUR PHILHEALTH BENEFITS

The following conditions must be met in order to avail your PhilHealth benefits:

1. Availment must be within the validity period as stated in Member Data Record (MDR) or in your payment receipt.
2. 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.
3. Benefit availment procedures for outright deduction of benefits

        - Submit to the PhilHealth Section the following prior to discharge:
               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.

PhilHealth Desk
Patient Services
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:

1. Signed Member Empowerment (ME) Form;
2. Age ›10 and ‹70 years;
3. Single organ transplant;
4. Patient on chronic dialysis because of end stage renal disease or patient for pre-emptive kidney transplantation with the following:

          - The potential recipient should have an irreversible renal disease that has 
            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

6. 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
7. Transplant candidate who is CMV-negative cannot receive an organ from a CMV-positive donor.
8. 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.)
9. 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.
10. 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.

(Source: PhilHealth)

Kidney Transplant Office
3/F Main Hospital Building
889-DLSMC (35762) ext. 7158
ktu@dlsmc.ph