QuestionsQuestions (PHILHEALTH CIRCULAR NO. 20, S. 2007)
It amends PhilHealth Circular No. 34, s. 2006 on the PhilHealth Newborn Care Package (NCP) and sets detailed guidelines on its implementation.
The package covers all eligible newborn dependents delivered in all accredited health facilities, including non-hospital maternity health care providers.
Services covered include administration of BCG vaccine and resuscitation of the newborn, among the enumerated services in the claim form.
The amount of the package remains at ₱1,000.
Claims from the facility shall not be compensated if it cannot provide the complete services covered by the package.
Yes. Payment may still be made for members within the amount of the package item enumerated in Circular No. 34, s. 2006, provided Official Receipt/s are attached to the claim.
Currently accredited facilities and those applying for initial, renewal, and re-accreditation must submit a photocopy of the Newborn Screening Facility (NSF) certificate issued by the Department of Health (DOH) or Newborn Screening Reference Center (NSRC) to PhilHealth Regional Offices’ Accreditation Department/Section on or before December 31, 2007.
All claims of PhilHealth accredited facilities for NCP with admission beginning January 1, 2008 that are not certified as NSF shall not be reimbursed.
Ideally after twenty-four (24) hours of life, but not later than three (3) days from complete delivery of the newborn.
Typically, claims within the three-day requirement are compensated. For newborns placed in intensive care to ensure survival, premature, and sick newborns, they may be exempted from the three-day requirement but must be tested within seven (7) days of age.
Yes. Official Receipt/s for NBS dated within the same period (even after discharge) shall be covered by the package.
The facility should indicate the filter collection card number of the NBS specimen, in Part IV (C), item no. 3 of the claim form.
The claim form shall be returned to the facility in case the facility is not able to indicate the said number.
They must be enumerated in Part IV (C) of the claim form as shown in the circular’s illustration (including items such as BCG/resuscitation and Newborn Screening test with filter collection card number).
All claim applications for NCP shall be coded using RVS code 99432, descriptive term “Normal Newborn Care Package.”
Yes. PhilHealth rules on ICD-10 shall also apply for this package.
They include: (1) duly accomplished Forms 1 and 2, (2) certificate of live birth, (3) clear copy of Member Data Record, and (4) proof of premium payment.
It takes effect for all claims with admission dates starting January 1, 2008. All other benefit availment rules inconsistent with these guidelines are repealed.