The Social Health Authority (SHA) has introduced new documentation requirements for contracted healthcare providers handling medical claims for children living under alternative care arrangements.
In a statement issued on Thursday, July 16, SHA explained that the new guidelines are aimed at reducing inconsistencies in claim documentation.
The Authority said it had observed inconsistencies in the documentation submitted to support claims for children under alternative care.
“To promote consistency in claims processing and ensure uninterrupted access to healthcare services for eligible beneficiaries, the Authority hereby guides the minimum documentary requirements applicable to the various categories of alternative care,” read the statement in part.
For adopted children, providers will now be required to submit a certified adoption order as proof of the care arrangement.
In cases of children under legal guardianship, providers must present either a deed or will appointing the guardian, or a certified court guardianship order.
Children placed under foster care must be supported by a Foster Care Placement Approval issued by the Secretary of Children’s Services or a relevant court order.
For children living in children’s homes, healthcare providers will need to provide a court committal or care order together with the child’s admission record from the institution.
In addition, SHA said claims involving kinship care must be supported by a custody order or a confirmation letter from a Children’s Officer.
Further, SHA specified that children placed with relatives through court orders must have a certified court order, while those under parental responsibility arrangements must be supported by the relevant legal instrument, such as a guardianship order, residence order or fit person order.
Meanwhile, children under the Kafaalah care arrangement, SHA will require either a Certificate of Registration (Form CK10) or a Placement Certificate (Form CK9).
