Question & AnswerQ&A (PHILHEALTH CIRCULAR NO. 20, S. 2007)
The PhilHealth Newborn Care Package (NCP) is a package that covers all eligible newborn dependents delivered in all accredited health facilities, including non-hospital maternity healthcare providers. It covers services such as administration of BCG vaccine and resuscitation of the newborn with a fixed amount of P1,000.
Qualified facilities must be accredited by PhilHealth and must be able to provide all required services covered by the package. They must also submit a photocopy of a Newborn Screening Facility (NSF) certificate issued by the Department of Health or Newborn Screening Reference Center to PhilHealth by December 31, 2007.
Claims from a facility that did not provide all required services will not be compensated. However, payment may still be made for covered items enumerated in Circular No. 34, s. 2006 if official receipts are attached to the claim application.
Newborn Screening should ideally be performed after 24 hours of life but no later than 3 days from complete delivery of the newborn. Exceptions allow premature, sick, or intensive care newborns to be tested within 7 days of age.
No, all claims from PhilHealth accredited facilities with admissions beginning January 1, 2008, that are not certified as NSF by DOH or NSRC will not be reimbursed.
Required documents include duly accomplished Forms 1 and 2, certificate of live birth, clear copy of Member Data Record, and proof of premium payment.
The filter collection card number of the NBS specimen collection form must be indicated in Part IV (C), item no. 3 of the claim form. Failure to indicate this number will result in the return of the claim form to the facility.
The Newborn Care Package is coded with the RVU code 99432, which stands for Normal Newborn Care Package.
The Circular took effect for all claims with admission dates starting January 1, 2008.
PhilHealth rules on ICD-10 shall apply to the Newborn Care Package claims.