Healthcare providers working with the Social Health Authority (SHA) will now be required to submit additional documents when seeking treatment approvals and processing claims for children living under alternative care arrangements.
The new guidelines, announced by SHA on Thursday, are intended to address inconsistencies that have been affecting the processing of claims and to ensure children continue accessing healthcare services without unnecessary delays.
According to the authority, some claims submitted by healthcare facilities lacked sufficient supporting documents, making it difficult to verify eligibility for children under different forms of 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,” SHA said in a notice.
The authority noted that the move follows the discovery of gaps in documentation submitted by healthcare providers.
Under the revised requirements, healthcare facilities must confirm that the necessary legal documents are available before submitting claims on behalf of children in alternative care.
For adopted children, providers will now be expected to attach a certified adoption order. Claims involving children under legal guardianship must be accompanied by either a deed of will appointing the guardian or a certified court order confirming the guardianship.
Children living under kinship care will require a custody order or a confirmation letter from a Children’s Officer, while foster care claims must include approval from the Secretary of Children’s Services or a relevant court order.
SHA has also outlined requirements for children living in charitable children’s institutions. Such claims must be supported by a court committal or care order together with admission records from the children’s home.
For children placed with relatives, providers will be required to submit a certified court order. Those under parental responsibility arrangements must provide documents such as a guardianship order, residence order or fit person order.
The authority also clarified the documentation needed under Kafaalah, an Islamic system of alternative family care. In such cases, claims must include either a Certificate of Registration (Form CK10) or a Placement Certificate (Form CK9).
SHA said the standardised documentation is expected to improve the efficiency of claims processing while safeguarding uninterrupted access to healthcare for eligible children.
The changes come at a time when the authority is continuing to process healthcare claims and clear pending reimbursements, amid increased public scrutiny over the speed and efficiency of payments to healthcare providers.