Question & AnswerQ&A (PHIC PHILHEALTH CIRCULAR NO. 07, S.2009)
The Newborn Care Package (NCP) is a PhilHealth benefit that may be availed by any qualified PhilHealth dependent delivered in accredited hospitals and non-hospital facilities certified as newborn screening facilities, covering newborn care services including newborn screening test, BCG, and Hepatitis B immunization.
Qualified dependents include babies delivered via cesarean section, breech extraction, or vaginal deliveries who are PhilHealth dependents.
Yes, a claim for the Newborn Care Package can be filed independently even if the mother's delivery is not covered by PhilHealth. The baby's claim need not be attached to the mother's claim for delivery.
The only required premium for dependents is three (3) months of contribution within the immediate six (6) months prior to delivery.
These services may be given on an outpatient basis since normal newborn babies can be sent home as soon as possible.
Incomplete provision of services includes immunization done in private doctors’ clinics and newborn screening tests done in another facility, separate from the accredited facility.
Claims must be submitted only after completion of the required newborn services such as newborn screening test, BCG, and Hepatitis B immunization if provided in Rural Health Units (RHU).
Resuscitation involves actions like suctioning and administration of oxygen to establish normal vital signs in newborns with abnormal breathing 1 minute after delivery or Apgar scores below 7. Normal babies do not require resuscitation.
No, claims for the Newborn Care Package are exempted from the submission of a Statement of Accounts.
No, home deliveries are not covered under Normal Spontaneous Delivery (NSD), Maternity Care Package (MCP), or Newborn Care Package (NCP). Members are advised to deliver only in PhilHealth-accredited facilities.
The NSD Package covers normal deliveries of the first four births in accredited hospitals, while the MCP covers the first four births in accredited non-hospital facilities such as lying-in clinics, birthing homes, or midwife-managed clinics.
The case rate is 4,500 pesos per case, which includes 2,000 pesos for professional fees in accredited hospitals.
MCP covers prenatal care, delivery, post-partum care, and family planning. Newborn care services are covered separately through the Newborn Care Package.
Yes, Rural Health Units and health centers are encouraged to apply for separate accreditation as providers of the maternity care package to be reimbursed for expenses related to MCP and NCP.
The Relative Value Unit (RVU) for treatment of incomplete abortion completed surgically is 40, not 60 as previously listed.