The Social Health Authority (SHA) has rolled out new documentation requirements for healthcare providers handling medical claims for children living under alternative care arrangements after identifying inconsistencies in supporting documents that have slowed the processing of healthcare services.
In a notice issued on Thursday, the authority said the new guidelines are meant to bring uniformity in claims processing across all contracted healthcare facilities while ensuring children who qualify for services continue receiving treatment without unnecessary delays.
"The Social Health Authority has observed inconsistencies in the documentation submitted in support of claims for children under alternative care arrangements," the authority said.
"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."
Under the new guidelines, healthcare providers submitting claims for adopted children will be required to attach a certified Adoption Order.
For children under legal guardianship, providers must submit either a deed or will appointing the guardian or a certified court guardianship order.
SHA also directed that claims involving children under kinship care must be accompanied by a custody order or a letter from a Children's Officer confirming the care arrangement.
The authority further outlined the requirements for other categories of alternative care. Claims involving children placed in foster care must include a Foster Care Placement Approval issued by the Secretary of Children's Services or a relevant court order.
For children living in charitable children's institutions, providers will be required to submit both a Court Committal or Care Order and the admission record from the children's home.
SHA said claims involving children placed with relatives must be supported by a certified court order.
Where claims relate to parental responsibility arrangements, healthcare providers will be expected to provide the relevant legal document, including a Guardianship Order, Residence Order or Fit Person Order.
The authority also introduced requirements for children placed under the Islamic Kafaalah system. In such cases, providers must submit either a Certificate of Registration (Form CK10) or a Placement Certificate (Form CK9).
SHA said the updated requirements are intended to create a standard approach to claims processing while safeguarding healthcare access for vulnerable children living outside the care of their biological parents.
The authority advised healthcare providers that require clarification on the new guidelines to contact SHA through its toll-free customer service number, 147.
It also urged all contracted healthcare providers to comply with the updated documentation requirements to support smooth claims processing and ensure eligible children continue receiving healthcare services without interruption.