QuestionsQuestions (PHIC PHILHEALTH CIRCULAR NO. 07, S.2009)
Any qualified PhilHealth dependent delivered in accredited hospitals and non-hospital facilities for MCP that are certified as a newborn screening facility.
No. A claim for the baby’s NCP is independent from the mother’s claim for delivery; a baby can still qualify for NCP even if the mother’s delivery is not covered.
Yes. Because the baby’s NCP claim is independent from the mother’s delivery coverage, babies of 5th and subsequent normal deliveries are also qualified for NCP.
No. The baby’s NCP claim need not be attached to the mother’s claim for delivery.
Only three (3) months of contribution within the immediate six (6) months prior to delivery.
Newborn screening test, BCG, and Hepatitis B immunization may be given on an outpatient basis because normal newborns can be sent home as soon as possible.
1) Immunization done in private doctors’ clinics, and 2) Newborn screening test done in another facility.
The member may be advised to file directly with PhilHealth.
Claims must only be submitted after completion of the required services: newborn screening test, BCG, and Hepatitis B immunization, if these are provided in the RHU.
No. Normal babies require no resuscitation.
Resuscitation is required only for newborns with abnormal breathing one (1) minute after delivery or newborns with Apgar scores below 7.
It should be included in Part IV c item No. 3 of PhilHealth Claim Form 2.
Yes. Claims for NCP are exempted from submission of Statement of Accounts.
No. Since home deliveries are not covered for NSD, MCP, or the Newborn Care Package, members are advised to deliver only in PhilHealth-accredited facilities.
NSD is the PhilHealth benefit for coverage of normal deliveries of the first four births in accredited hospitals.
It is termed the Maternity Care Package (MCP).
The case rate remains the same at ₱4,500 per case, including ₱2,000 for professional fee in accredited hospitals.
Prenatal care, delivery, post-partum care, and family planning.
Newborn care services previously covered by MCP may now be covered separately through the Newborn Care Package (as per PhilHealth Circular No. 20 series of 2007).
Relative Value Unit for treatment of incomplete abortion completed surgically (RVS Code 59812) remains at 40, not 60.