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Wednesday, September 06, 2006
Philhealth expands NSD coverage
The Philippine Health Insurance Corp. (Philhealth) will reimburse uncomplicated deliveries of the first three births in accredited hospitals and lying-in clinics starting Oct. 1.
The expansion of the normal spontaneous delivery (NSD) package was provided by Philhealth Board Resolution 923 series of 2006.
A case rate of P4,500 will be paid to accredited providers of the NSD and maternity care package.
For hospitals, payment for accredited health professionals is set at P2,000, while P2,500 for the facilities.
Consultations
In lying-in clinics and analogous facilities, the first payment of P3,650 is paid after delivery and the second payment of P850 is paid after the post-natal consultations and family planning services.
Normal birth is characterized by spontaneous onset of labor, low risk at the start of labor and throughout labor and delivery.
The fetus must be in vertex position and is at 37 to 42 weeks.
An additional requirement for the availment of the benefit in lying-in clinics is the first pre-natal visit for the patient must not
exceed the 16 weeks age of gestation.
Exemptions
However, those excluded from coverage when giving birth in Philhealth-accredited lying-in clinics are those under 19 years old, having their first pregnancy when they are 35 years old and older, with multiple pregnancies, ovarian cyst, myoma uteri, placenta previa or breech presentation.
Also excluded are those with history of three or more miscarriages, stillbirth, major obstetric or gynecologic operation (Caesarean section, uterine myomectomy), medical conditions like hypertension, pre-eclampsia, eclampsia, heart disease, diabetes, thyroid disorder, morbid obesity, moderate to severe asthma, epilepsy, renal disease and bleeding disorders.
For Bisaya stories from Cebu. Click here. (September 6, 2006 issue)
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