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Philippine Charity Sweepstakes Office PCSO Hemodialysis and Peritoneal Dialysis Assistance.

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Presentation on theme: "Philippine Charity Sweepstakes Office PCSO Hemodialysis and Peritoneal Dialysis Assistance."— Presentation transcript:

1 Philippine Charity Sweepstakes Office PCSO Hemodialysis and Peritoneal Dialysis Assistance

2 Philippine Charity Sweepstakes Office Individual Medical Assistance Program Individual Medical Assistance Program (IMAP)The Individual Medical Assistance Program (IMAP) is the flagship program of the Philippine Charity Sweepstakes Office that gives financial assistance for health-related needs, including hemodialysis (HD) and peritoneal dialysis (PD)

3 Philippine Charity Sweepstakes Office Assistance for HD and PD under the IMAP One of the top three (3) most requested types of assistance under the IMAP YearNo. of Beneficiaries Amount of Assistance Granted Rank 201422,722P 466,097,111.012 nd 201515,516P 310,991,740.003 rd

4 Philippine Charity Sweepstakes Office Assistance for HD and PD under the IMAP Previous rates: –Hemodialysis For procedure: P 20,000.00 every other month –Peritoneal Dialysis For dialysis solutions: maximum assistance of P35,000.00 every other month Delivery scheme under the enrolment system for HD and PD

5 Philippine Charity Sweepstakes Office Assistance for HD and PD under the IMAP Suspended in August 2015 for review due to publication and implementation of PhilHealth Circular No. 022-2015 –Increased number of claims under the Case Rate Scheme for hemodialysis and peritoneal dialysis from 45 to 90 claims Also with the implementation of the Z benefit package for peritoneal dialysis in 2014, which assured patients assistance amounting to P270,000.00 per year

6 Philippine Charity Sweepstakes Office Introducing the New Assistance Scheme for Hemodialysis and Peritoneal Dialysis under the IMAP…

7 Philippine Charity Sweepstakes Office Assistance for HD and PD under the IMAP ASSISTANCE FOR PHILHEALTH MEMBERS For HemodialysisFor Peritoneal Dialysis 1. A maximum annual assistance of P84,000.00 for medicines (epoietin) shall be made available at P14,000.00 per claim for a total of six (6) claims per year P14,000.00 x 6 (claims) = P84,000.00/year 2. Assistance may be processed and released monthly/ every other month or at any time upon presentation of certification of ongoing treatment from attending physician 1. A certification of the type of PhilHealth benefit package under peritoneal dialysis must be presented to determine the appropriate form of assistance 2. For those under the Z package, a maximum annual assistance of P84,000.00 for medicines (epoeitin) shall be made available at P14,000.00 per claim for a total of six claims per year. P14,000.00 x 6 claims = P84,000/year 3. For those under case rate scheme, a maximum annual assistance of P120,000.00 for dialysis solutions shall be made available at P20,000.00 per claim for a total of six claims per year P20,000.00 x 6 claims = 120,000.00/year 4. Assistance may be processed and released monthly/ every other month anytime upon presentation of certification of ongoing treatment from the attending physician

8 Philippine Charity Sweepstakes Office Assistance for HD and PD under the IMAP ASSISTANCE FOR NON-PHILHEALTH MEMBERS For HemodialysisFor Peritoneal Dialysis 1. A maximum assistance of P20,000.00 (for procedure) every other month 1.Maximum assistance of P35,000.00 (for dialysis solution) every other month 2.To submit a certification of PHIC non-membership from the attendant dialysis center

9 Philippine Charity Sweepstakes Office Assistance for HD and PD under the IMAP Will be implemented under the Enrolment System –Enrolment scheme shall be applicable for one (1) calendar year –Total of six (6) claims for the year

10 Philippine Charity Sweepstakes Office Documentary Requirements: At Enrolment For PhilHealth Members/PD Z package (HD and PD Patients) For PhilHealth Non Members (HD and PD Patients) For Medicines (Epoeitin) Request Existing Case Rates (Hemodialysis treatment and Peritoneal Solutions) 1 st Claim – upon Enrolment – patient is required to appear  Accomplished Application Form (to be scanned for the succeeding claims)  Original Medical Abstract duly signed by the Nephrologist/attending physician with license number (to be scanned by the SWer for the succeeding claims)  Prescriptions  Prescriptions (PD requests only)  Official quotation from the dialysis centers/hospitals (to be scanned by the SWer for the succeeding claims for medicines/hemodialysis treatment)  Updated laboratory results  Certification of Acceptance of GL from the dialysis center/hospitals  Certification of Philhealth membership status (member/non-member) including type of package for PD (Z or case rate)  Valid ID (patient and designated representative if there is any for the succeeding releases)

11 Philippine Charity Sweepstakes Office Documentary Requirements: At Succeeding Claims For Phil health Members/Z package (HD and PD Patients) For Non Phil health Members (HD and PD Patients) For Medicines (Epoeitin) Request Existing Case Rates (Hemodialysis treatment and Peritoneal Solutions) At Succeeding claims – patient has the option to designate a representative  Certification of ongoing treatment including the last date of treatment from the Nephrologist/attending physician  Index Card/client social worker agreement  Original Prescriptions PCSO-CAD will issue index card/client-social worker agreement upon enrolment which the patient/representative have to present upon the succeeding releases

12 Philippine Charity Sweepstakes Office Maraming salamat po! www.pcso.gov.ph

13 Philippine Charity Sweepstakes Office

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