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Manual For MOH Hospital

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0% found this document useful (0 votes)

294 views76 pages

Manual For MOH Hospital

Circular

Uploaded by

Aswad Manap

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You are on page 1/ 76

REF. NO.

:
PHC-PK/600-1/3

MANUAL
FOR
MINISTRY OF HEALTH HOSPITAL

www.pekab40.com.my
TABLE OF CONTENTS

GENERAL INFORMATION ................................................................................................................ 3

1.1 PURPOSE AND AUDIENCE .............................................................................................. 3

1.2 BACKGROUND .................................................................................................................... 3

1.3 THE BENEFITS MANAGEMENT SYSTEM ..................................................................... 3

1.4 PERSON IN CHARGE (PIC) .............................................................................................. 4

1.5 COMMUNICATION .............................................................................................................. 4

HEALTH AID BENEFIT ...................................................................................................................... 5

2.1 ABOUT THE BENEFIT ........................................................................................................ 5

2.2 TERMS AND CONDITIONS FOR APPLICATION.......................................................... 5

2.3 TYPES OF HEALTH AID CATEGORIES ......................................................................... 6

2.4 DETAILED LIST OF HA BY CATEGORIES - SURGICAL CATEGORIES ................ 6

2.5 DETAILED LIST OF HA BY CATEGORIES - NON-SURGICAL CATEGORIES ...... 9

2.6 APPLICATION PROCESS ............................................................................................... 10

2.7 REJECTION OF APPLICATION ..................................................................................... 14

2.8 CO-PAYMENT PROCESS ................................................................................................ 14

2.9 REVIEW OF APPLICATION............................................................................................. 15

2.10 APPROVAL OF APPLICATION ...................................................................................... 15

2.11 OVERALL TAT FOR HA APPROVAL ........................................................................... 16

2.12 DELIVERY TIME AND VERIFICATION ......................................................................... 17

2.13 PAYMENT OF HEALTH AID ............................................................................................ 17

2.14 HA WORKFLOW: PRE-HA APPROVAL FLOW .......................................................... 19

2.15 HA WORKFLOW: POST- HA APPROVAL FLOW ...................................................... 20

COMPLETING CANCER TREATMENT INCENTIVE (CCTI)..................................................... 21

3.1 ABOUT THE BENEFIT ...................................................................................................... 21

3.2 ELIGIBILITY ........................................................................................................................ 21

3.3 AUTHORISED USERS FOR CCTI .................................................................................. 22

3.4 CCTI APPLICATION & FIRST PAYMENT OF THE INCENTIVE .............................. 23

3.5 TRANSPORT INCENTIVE AND FOLLOW UP MODULE ........................................... 24

3.6 SECOND PAYMENT OF THE INCENTIVE ................................................................... 24

3.7 CCTI WORKFLOW ............................................................................................................ 25

PeKa B40 Manual for MOH Hospital
Copyright © 2019 ProtectHealth Corporation Sdn. Bhd
All Rights Reserved
Page | 1
TRANSPORT INCENTIVE ............................................................................................................... 26
4.1 ABOUT THE BENEFIT ...................................................................................................... 26

4.2 APPLICATION OF TRANSPORT INCENTIVE ............................................................. 28

4.3 PAYMENT............................................................................................................................ 28

4.4 TRANSPORT INCENTIVE WORKFLOW DIAGRAM .................................................. 30

HEALTH ASSESSMENT .................................................................................................................. 31

5.1 CRITERIA FOR HEALTH ASSESSMENT IN MOH HOSPITAL ................................ 31

5.2 HEALTH ASSESSMENT COMPONENTS ..................................................................... 31

5.3 HEALTH ASSESSMENT PROCESS .............................................................................. 31

5.4 HOSPITAL RECORD......................................................................................................... 33

5.5 BENEFICIARY CONSENT ............................................................................................... 33

5.6 UPDATING BENEFICIARY’S INFORMATION ............................................................. 33

5.7 HEALTH ASSESSMENT FORMAT ................................................................................ 34

5.8 PROVISIONAL DIAGNOSIS ............................................................................................ 35

5.9 LABORATORY INVESTIGATIONS ................................................................................ 35

5.10 CONSULTATION AND REFERRAL ............................................................................... 35

5.11 ENTERING HEALTH ASSESSMENT DETAILS INTO BMS ...................................... 35

5.12 HEALTH ASSESSMENT WORKFLOW ......................................................................... 36

UPDATING REFERRAL CASES .................................................................................................... 37

6.1 INTRODUCTION ................................................................................................................ 37

6.2 UPDATING REFERRAL WORKFLOW .......................................................................... 37

APPENDIX .......................................................................................................................................... 39

PeKa B40 Manual for MOH Hospital

1.1 PURPOSE AND AUDIENCE

This PeKa B40 Manual for Ministry of Health (MOH) Hospital (“Manual”) is intended
to provide a clear description of the requirements, processes, and working
arrangement between the MOH Hospital staff (MOH staff) and ProtectHealth
Corporation Sdn Bhd (ProtectHealth) for the “Peduli Kesihatan untuk Kumpulan B40”
(PeKa B40) scheme.

This Manual provides explanation about the PeKa B40 Benefits in the setting of a
Hospital. The Manual is subjected to revision from time to time, at which MOH staff
will be informed. This Manual is to be used as guidance for MOH Staff. Nothing in
this Manual should be interpreted in a way that would be inconsistent with
compliance to existing laws and regulations or professional duties

1.2 BACKGROUND

PeKa B40 is an initiative by the Government through the Ministry of Health (MOH)
aimed at improving the wellbeing of the low-income group, focusing especially on
reducing the burden of non-communicable diseases (NCDs). It is being implemented
in phases, beginning with a nationwide pilot project that includes approximately
800,000 eligible persons in its first phase, and it shall be fully run by ProtectHealth.

Through PeKa B40, beneficiaries will receive four health-related benefits. These
benefits are:

• Benefit 1: Health Screening

• Benefit 2: Health Aid Benefit 2,3 and 4 are
• Benefit 3: Completing Cancer Treatment Incentive only available if treated
• Benefit 4: Transport Incentive in MOH Hospital

PeKa B40 beneficiaries must complete Health Screening (i.e. Benefit 1) as the
prerequisite prior to receiving Health Aid, Completing Cancer Treatment Incentive
(CCTI) and/or Transport Incentive. Health Screening can be done at PeKa B40
General Practitioner (GP) Clinics or Klinik Kesihatan. In the event that the beneficiary
is hospitalised in MOH Hospital, and the need for Benefit 2 and 3 is urgent, Health
Assessment in MOH Hospital can be done in hospital as an alternative to complete
Benefit 1 (Section 5 on Health Assessment)

1.3 THE BENEFITS MANAGEMENT SYSTEM

All transactions and activities relating to the PeKa B40 scheme must be recorded
and conducted through the Benefits Management System (BMS). BMS is a web-
based system or web portal that can be accessed through any computer or laptop

PeKa B40 Manual for MOH Hospital

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with internet access. It is also mobile responsive, although not fully mobile-friendly.
The user manual for the use of the BMS is made available in the web portal.

BMS Website: https://bms.pekab40.com.my/site/login

1.4 PERSON IN CHARGE (PIC)

1.4.1 PIC Appointment

All departments of MOH Hospital involved in PeKa B40 Scheme will appoint a PeKa
B40 Person in Charge (PIC). PICs will be trained and act as the the liaison officer
between MOH Hospital and ProtectHealth for PeKa B40. Therefore, MOH staffs must
identify their respective PIC and refer to the PIC if there are any related matters. This
is to ease communication between health facilities and ProtectHealth.

1.4.2 Roles and Responsibilities of PIC

a) PIC will be registered as ‘Primary Account Holders’ in BMS for their respective
departments.
b) Determine the user access for the staffs in their department and register them as
‘Authorised Users’ for BMS according to their tasks.
c) Ensure all required information are entered in BMS and all documents required
are submitted.
d) Maintain and update the ‘Authorised Users’ as required:
• Register new users,
• Deactivate/delete inactive users.
e) Maintain records pertaining to PeKa B40 scheme.
f) Ensure all hard copy forms (if needed by respective departments) are readily
available.
g) Become the liaison person for PeKa B40 related matters.

1.5 COMMUNICATION

Any enquiries, complaint or any form of feedback can be directed to ProtectHealth as

below;

Toll-Free number 1-800-180-755

Contact center +603-8687 2588
Fax +603 8687 2599
Email [email protected]

Please note that the Toll-Free Number is developed specifically for MOH facilities
and should not be shared to beneficiaries or GPs.

PeKa B40 Manual for MOH Hospital

2.1 ABOUT THE BENEFIT

2.1.1 Introduction
Treatment charges at MOH Hospitals are heavily subsidised by the Government
except for certain items or medical devices of which the cost is borne by patients.
Therefore, this benefit aims to cover cost incurred for these items to ease the
financial burden specifically for the B40 population.

2.1.2 Definition of Health Aid

Health Aid (HA) refers to medical devices or items that are required for treatment,
improvement of quality of life or functionality and for rehabilitative purpose.

2.1.3 PeKa B40 HA Benefit

This benefit offers health item which is currently not subsidised in MOH hospitals.

It has a lifetime limit of RM 20,000 per beneficiary (head of household and

spouse). HA under PeKa B40 scheme will cover ten (10) HA categories as
stated in Section 2.4 and 2.5

2.2 TERMS AND CONDITIONS FOR APPLICATION

2.2.1 Prerequisite for HA

a) Open to all PeKa B40 beneficiaries

b) The application must be made at the Ministry of Health (MOH) Hospital
ONLY
c) The HA item requested is in the listed HA categories as stated in
Section 2.4 and 2.5
d) The lifetime limit for HA is still available
e) Beneficiaries must complete the Health Screening under PeKa B40
scheme

2.2.2 Exclusions

a) Not a PeKa B40 beneficiaries

b) HA item needed in urgent cases (within 24-48 H)
c) Exhausted the RM 20,000 limit

PeKa B40 Manual for MOH Hospital

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2.2.3 Price Range
Each HA items covered under this benefit have a price range specified by
ProtectHealth. Ideally, the HA applied must not exceed the upper limit of the price
range. However, for HA application that is beyond the price range, additional process
options come into effect. This will be further explained in Section 2.6.5 (c).

2.3 TYPES OF HEALTH AID CATEGORIES

2.3.1 Definition:

a) Surgical HA are HAs requiring surgical procedures

b) Non-Surgical HA are HAs not requiring any surgical procedure

2.3.2 There are ten (10) categories of HA covered under this benefit. The categories are
further divided into two groups; Surgical HA and Non-Surgical HA. These can further
be categorised into:

2.4 DETAILED LIST OF HA BY CATEGORIES - SURGICAL CATEGORIES

2.4.1 Cardiac Stent

a) Drug-Eluting Balloon
b) Drug Eluting Stent
c) Bioabsorbable Scaffolds
d) Aortic Stent Graft for Aortic Aneurysm
e) Inoue Balloon for Mitral Commissurotomy (for PTMC)

2.4.2 Pacemaker
a) Single Chamber Pacemaker VVIR
b) Dual Chamber Pacemaker
c) Implantable Cardioverter Defibrillator (ICD)
• Single Chamber ICD
• Dual Chamber ICD
d) Biventricular, Cardiac Resynchronization (CRTP)
e) Biventricular, Cardiac Resynchronization with ICD (CRTD)

PeKa B40 Manual for MOH Hospital

a) Primary total hip arthroplasty

b) Primary total hip arthroplasty hybrid
c) Primary total hip arthroplasty young (<56 years old)
d) Revision total hip arthroplasty
e) Complex primary total hip replacement
f) Primary total knee replacement
g) Complex primary total knee replacement:
• Hinged knee
• Complex primary tibia/femur augment with stem & bone graft
h) Revision total knee replacement (rotating hinged knee with stems & bone graft)
i) Total shoulder replacement
j) Hemi-shoulder
k) Reverse shoulder
l) Total elbow replacement
m) Total ankle replacement
n) Wrist arthroplasty
o) Small joint surface replacing arthroplasty
p) Small joint silastic / silicone arthroplasty

2.4.4 Spinal Surgery Prosthesis and Implants

a) Scoliosis instrumentation
b) Anterior cervical fusion system (single level)
c) Posterior cervical plate (lateral plate)
d) Posterior cervical and lateral mass screw/pedicle screw with occipital plate
e) Triple wires/cables
f) Spinal cages (titanium cage)
g) Expandable cage
h) Spinal Fusion
• Posterior Lumbar Interbody Fusion (PLIF) cage
• Transforaminal Lumbar Interbody Fusion (TLIF) cage
• Anterior Lumbar Interbody Fusion (ALIF) cage
i) Anterior spinal implants
j) Anterior spinal implants with titanium cage
k) Pedicle Screws
• Four (4) pedicle screws with one (1) cross link
• Eight (8) pedicle screws one (1) cross link
l) Revision of spinal surgery
m) Spinal tumour reconstruction prosthesis
n) Interspinous Spacer

PeKa B40 Manual for MOH Hospital

Orthopaedic related
a) Proximal / Distal femur endoprosthesis
b) Proximal tibia endoprosthesis
c) Total femur prosthesis
d) Proximal / Distal humerus endoprosthesis
e) Total humerus / elbow / scapula endoprosthesis
f) Oncology bipolar hemiarthroplasty
g) Intercalary endoprosthesis
h) Allo-prosthesis composite reconstruction
i) Allograft bone (all types)
j) Bone substitute (Hydroxyapatite) 10g
k) Saddle prosthesis
l) Long knee arthrodesis nail
m) Radial head hemiprosthesis

Rehabilitative related
n) Upper Limb Prosthesis
• Transhumeral
• Transradial
o) Hip disarticulation prosthesis
p) Transfemoral prosthesis (Above knee)
q) Knee disarticulation prosthesis
r) Transtibial prosthesis (Below knee)
s) Syme’s foot prosthesis
t) True knee prosthesis
u) Knee prosthesis/ Knee orthosis
v) Partial foot amputation prosthesis
w) Foot/ ankle foot/ ankle foot orthosis (hinged)
x) Knee ankle foot orthosis
• Solid ankle
• Articulated ankle joint
y) Thoracolumbosacral orthosis (TLSO)
• Ready-made
• Custom made

2.4.6 Intraocular Lens

PeKa B40 Manual for MOH Hospital

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2.5 DETAILED LIST OF HA BY CATEGORIES - NON-SURGICAL CATEGORIES

2.5.1 Hearing Aid

a) Behind the ear for the adult (less than 60 years old) with the type of hearing loss
as below:
• Conductive
• Sensorineural
• Mixed
b) Behind the ear or in the ear (ITE) for elderly (60 years old and above) with the
type of hearing loss as below:
• Conductive
• Sensorineural
• Mixed
c) Bone Conduction Hearing Aid for any age with the type of hearing loss as below:
• Conductive
• Mixed
d) Bone Anchored Hearing Aid (BAHA) for the adult with the type of hearing loss as
below:
• Bilateral conductive
• Bilateral mixed

2.5.2 Breathing machines & oxygen concentrator

a) BiPAP (Bilevel positive airway pressure)
b) CPAP (Continuous positive airway pressure)
c) Oxygen Concentrator not including portable models
d) Oxygen tank

2.5.3 Nutritional support

Manufacturer Nutritional Support Brand Name

Ensure Powder (Chocolate/ Vanilla)

Ensure Gold Powder

Abbot Glucerna Triple Care Powder

Nepro High Protein (Hp)

Prosure (Vanilla/Orange)

Valens Calco High Calorie

Valens Modular Whey Protein (Myotein)

Valens Carborie

Wyeth Enercal Plus

PeKa B40 Manual for MOH Hospital

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Manufacturer Nutritional Support Brand Name

Nutren Fibre

Nutren Optimum (Vanilla)

Nutren Diabetik

Peptamen (Vanilla)
Nestle
Isosource 1.5 Cal

Nutren Diabetes (Liquid)

Resource Peach Flavour

Peptamen (Vanilla)

Kotra Pharma Appeton Wellness (Recovery)

Nutricia Basic F

Optimax Lite
British Biological, India
Supplement D
Table 2: Nutritional Support

2.5.4 Wheelchair
a) Manual standard fixed arm & footrest – Standard wheelchair
b) Manual lightweight with detachable arm & footrest – DAF wheelchair lightweight
c) Manual heavy duty with detachable arm & footrest – Heavy duty wheelchair
d) Manual reclining with detachable arm & elevated footrest – DAF recliner
wheelchair
e) Standard motorized wheelchair
f) Customized seating system wheelchair
g) Tilt in space wheelchair
h) Manual wheelchair & adaptive system
i) Tilt-in recline with wheelchair with custom made seating & position – Tilt in space
with seating system
j) Custom made seating & positioning system
k) Foam cushion

2.6 APPLICATION PROCESS

2.6.1 The HA application process is similar to the current Tabung Bantuan Perubatan
(TBP) application at MOH Hospital. PeKa B40 HA application will also use the Form
C of TBP but will not require Medical Social Worker (MSW) to do Socioeconomic
Assessment. This further explained in Section 2.6.4.

PeKa B40 Manual for MOH Hospital

Application for health aid must be from the respective department where
the beneficiary receives his/her treatment

For example:
• Spinal Surgery Prosthesis and Implants: Application from the spinal surgeon
• Limb prosthesis and orthosis (rehabilitative related): Application from a
rehabilitative specialist

2.6.3 Step 1: Treating Doctor Refer Case to MSW

a) Treating doctor must:

• Be a Medical Officer/ Specialist at MOH Hospital

• Fill in the Form C (Appendix 1) of TBP and MSW Referral Letter
(Borang Rujukan)
• Provide phone number and email to MSW
• Obtain three quotations, from three different vendors for HA
• Provide supporting documents and fulfil requirements for HA
application where necessary (Refer to Section 2.6.2 (c))
• Refer MSW for HA application

b) Disclaimer
i. Doctor is responsible to choose the most suitable HA items and reliable
vendor to avoid undesired complications.
ii. ProtectHealth is not liable to any loss, damage, injury, death, delay, or
complications as a result from the treating doctor’s choice of HA and
vendors.

c) Supporting Documents and Requirements for certain HA categories

i. Certain HA item must fulfil the specific requirement as specified in Table 3.

HA Categories Requirements

Nutritional support Dietitian recommendation.

Breathing machine and BiPAP

Oxygen concentrator • Cases that require BiPAP from other
disciplines besides pulmonology should
be referred to a pulmonologist.

PeKa B40 Manual for MOH Hospital

CPAP
This item can be applied by:
• Pulmonologist.
• ENT specialist with sub-specialty in sleep
disorder.
• ENT specialist can apply for obstructive
sleep apnea (OSA) cases only with sleep
study results as below:
Breathing machine and o CPAP result trial.
Oxygen concentrator o The patient can use CPAP
comfortably and there is evidence
of improvement in the patient’s
condition.

Oxygen Concentrator
• Portable Oxygen Concentrator is not
included.
• The application must be supported with
ABG result.
Table 3: Supporting Documents and Requirements

d) Guidelines for vendor selection

For the purpose of ensuring the best HA supplied to the beneficiary, the treating
doctor must choose the vendor according to the criteria below:
• Vendor must have Medical Device Authority license
• Prioritise local/nearby suppliers to provide equipment to beneficiaries, for
easy facilitation of after-sales service (example: maintenance, repair, and
warranty).
• Prioritise vendors who are easy to reach, provide good service, and attentive
to any problems faced by patients and hospitals.
• Prioritise vendors with the necessary proficiency, knowledge, and technical
expertise in managing patient needs.

2.6.4 Step 2: Application of HA by Medical Social Worker (MSW)

a) MSW must first be registered as Authorised Users in BMS.
b) Receive Form C from the treating doctor
c) Enter NRIC of the applicant in BMS to check eligibility for HA. Applicant will
be eligible if :
i. they are Peka B40 beneficiaries
ii. the lifetime limit balance is still available
iii. the item requested in the listed HA items
iv. they have done PeKa B40 Health Screening
d) Complete the online HA application

PeKa B40 Manual for MOH Hospital

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e) Upload or fax required documents to ProtectHealth. The required documents
include:
i. Form C (Borang C) as in Appendix 1
ii. Three quotations
iii. Relevant supporting documents as in Table 3

There is no requirement for MSW to do socio-economic evaluation

2.6.5 Issues Related to HA Application

a) No Health Screening Done

i. If beneficiaries have not done PeKa B40 Health Screening, MSW can
still proceed with the application. However, there will be a notification
informing that HA application will only be processed and approved
after beneficiaries' Health Screening data is entered into the system
ii. MSW must inform the treating doctor to remind beneficiaries to go for
Health Screening at PeKa B40 registered General Practitioner
iii. However, if a beneficiary is currently admitted and unable to be
discharged until they receive the HA, doctors in Hospital can do Health
Assessment. Please refer to Section 5 on Health Assessment.

If no Health Screening done, there will be a notification informing that HA

application will only be processed and approved after beneficiaries'
Health Screening data is entered into the system

b) Balance inadequate
i. After MSW submit application, if the balance is inadequate, beneficiary
can co-pay.
ii. Application will be reviewed by ProtectHealth and Co-Payment Letter
(Appendix 3) can be downloaded from the BMS. It will also be
emailed to the treating doctor, MSW and beneficiary
iii. Treating doctor is responsible to inform and ask the beneficiary
whether he/she agrees to co-pay.
iv. The beneficiary has to agree to co-pay and the agreement has to be
submitted to ProtectHealth (Appendix 3). Refer to Section 2.8 on Co-
Payment for the detailed process.

c) HA Quotation Exceeds the Price Range

i. If the HA quotation exceeds the price range, ProtectHealth will email
the treating doctor informing and notify them to negotiate the HA price.
ii. Treating doctor must give feedback on the negotiated price within
fifteen (15) working days from the date of notification.

PeKa B40 Manual for MOH Hospital

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iii. The negotiation is considered as unsuccessful if:
• negotiated price still exceeds the price range
• no feedback from the treating doctor after fifteen (15) days
iv. In the event of unsuccessful negotiation, the beneficiaries can co-pay.
Refer to Section 2.8 on Co-Payment process.

If HA price exceeds price range, treating doctor needs to negotiate the

price with the vendor. Feedback on the negotiated price should be
submitted within fifteen (15) working days

2.7 REJECTION OF APPLICATION

If the application is rejected due to any of the reasons below, a Rejection Letter to
indicate unsuccessful application (as in Appendix 2) can be downloaded from the
BMS to be given to the beneficiary, if there is a need.

a) Inadequate balance, and beneficiaries unable to co-pay.

b) HA price is outside the price range, and beneficiaries unable to co-pay
c) HA is not in the ten (10) listed HA categories

2.8 CO-PAYMENT PROCESS

2.8.1 There are two (2) types of co-payment process:

a) Co-payment due to inadequate HA balance

b) Co-payment due to price exceeding price range

2.8.2 For Co-Payment process, ProtectHealth will issue a Co-Payment Letter

(Appendix 3) which can be downloaded from the BMS. It will also be emailed to
the treating doctor, MSW and beneficiary.

2.8.3 Treating doctor is responsible to inform and ask the beneficiary whether he/she
agrees to co-pay. The beneficiary is given thirty (30) days to decide and sign the
Co-Payment letter indicating their decision to co-pay.

2.8.4 MSW will email the signed Co-Payment letter to ProtectHealth or upload it in the
BMS.

2.8.5 ProtectHealth will review the letter. If the beneficiary agrees for Co-Payment, the
vendor will communicate directly with the beneficiary or next of kin for the co-
payment.

2.8.6 However, if the beneficiaries were unable or do not agree to co-pay,

ProtectHealth will issue a Rejection Letter. (Refer to Section 2.7)

PeKa B40 Manual for MOH Hospital

2.9.1 Claim Review by ProtectHealth

All application request will be reviewed by ProtectHealth. ProtectHealth will ensure
the HA requested fulfilled all the prerequisite requirement.
a) Claim Department will review based on:
• HA requested is from the relevant department.
• All supporting documents provided
• Accurate information provided in quotations
b) Finance Department will give clearance based on the availability of PeKa B40
fund.

2.9.2 Turn-Around-Time for Review and Approval

The Turn-Around-Time (TAT) for HA quotation selection and approval is

within five (5) working days. However, for HA application that require
negotiation, co-payment and/or other issues, this process may take a
longer time for approval.

2.10 APPROVAL OF APPLICATION

2.10.1 Successful Vendor

Successful Vendor is the vendor providing the quotation selected by
ProtectHealth. Successful vendor will be notified by email. They are required to
register/update their company profile in the BMS within three (3) working days. In
the event vendors failed to register within the three (3) days, vendors will be
notified by ProtectHealth. The unsuccessful vendor will also receive an email to
notify that their quotation is rejected.

Vendors are required to register/update their company profile in the BMS

within three (3) working days following approval of HA

2.10.2 Registration of Successful Vendor

Successful vendor must register or update information with ProtectHealth through
the BMS. The information required for registration of vendors are as follows:
a) Company Name
b) Address
c) email
d) Phone number
e) SSM registration number
f) Medical Device Registration Certificate/Notification of Low Risk Medical
Device
g) Establishment Licence under Medical Device Act 2012 (Act 737) or
Appointment Letter as Tenderer Agent (Surat Pelantikan Sebagai Ejen
Penender)
PeKa B40 Manual for MOH Hospital
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h) Health items supplied
i) Bank Account Number
j) Swift code

2.10.3 Letter of Award (LOA)

After successful registration, vendors can download the LOA (Appendix 4) from the
BMS. Vendors should upload the signed LOA within three (3) working days. The copy
of the signed LOA will be available in BMS for download and to be given to Hospital
Director, Head of Department (HOD), treating doctor and beneficiaries. Beneficiaries
will also receive SMS/whatsapp notification from ProtectHealth to inform that the HA
application had been approved.

2.10.4 Validity of LOA

Validity period for approved HA is:

• Surgical HA - one (1) year from the date of LOA issued
• Non-Surgical Items - six (6) months from the date of LOA issued

If HA is not used within the validity period, the beneficiary needs to reapply.

2.11 OVERALL TAT FOR HA APPROVAL

2.11.1 In summary the overall TAT for HA approval is as illustrated in the Figure 1

Figure 1: Summary of HA Approval TAT

a) Application submission – is the date when MSW submit the application. In the
event when Health Screening is not done, MSW may still submit application.
However, the HA application will only be processed after Health
Screening/Assessment information is entered in the BMS
b) Quotation Selected - ProtectHealth will take maximum of five (5) working days
to process the application and select quotation
c) Vendor Registration – Once a quotation is selected, the successful vendor is
given three (3) working days to register / update their information in the BMS

PeKa B40 Manual for MOH Hospital

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d) Vendor Registration Approved and LOA Issued – After registration,
ProtectHealth will approve Vendor registration and LOA will be issued within
three (3) working days

2.12 DELIVERY TIME AND VERIFICATION

Health aid must be delivered on its specified time and verification is required in order
to allow payment to the vendors.

2.12.1 Delivery time

a) Surgical HA: Vendors should deliver the HA before surgical operation/

procedure
b) Non-Surgical HA: Vendors should deliver the HA after submission of
signed LOA.

2.12.2 Verification of Delivery and Utilisation

In ensuring the HA is being delivered and utilised appropriately, the vendor must
obtain verification from the treating doctors/MSW/relevant MOH Hospital staff. The
verification process is a prerequisite for payment approval for vendors. The process
of verifications for Surgical and Non-Surgical HA are as the following:

a) Surgical HA - Vendor should obtain the signature and official stamp from the
treating doctor for the consignment note (refer to Section 2.12.3 below) after
surgery done
b) Non-Surgical HA - Vendor should obtain the signature and official stamp from
MSW/relevant MOH Hospital staff for the consignment note (refer to Section
2.12.3 below)

2.12.3 Consignment Notes

The consignment notes (Appendix 5) can be downloaded from the BMS. Vendor
must upload the signed consignment note into the BMS within 1 month from the date
of surgery/delivery of HA item.

2.13 PAYMENT OF HEALTH AID

Conditions for payment: Vendor upload complete consignment note and

invoice into the BMS system

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2.13.1 Payment to Vendors
Payment to the vendors by ProtectHealth will be done according to the payment
schedule as in Table 4 below:

Date Invoice sent by vendors Date of payment to

to ProtectHealth vendors by ProtectHealth
1st to 12th of the month 15th of the month
13th to 27th of the month 30th of the month

28th to 30th/31st of the month 15th of the following month

Table 4: Payment schedule

PeKa B40 Manual for MOH Hospital

Figure 2: HA Workflow Process: Pre-HA Approval Flow

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Page | 19
2.15 HA WORKFLOW: POST- HA APPROVAL FLOW

Figure 3: HA Workflow Process: Post-HA Approval Flow

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COMPLETING CANCER TREATMENT INCENTIVE (CCTI)

3.1 ABOUT THE BENEFIT

3.1.1 Introduction
Data from the National Health Cancer Registry shows an alarming increase on the
incidence of cancer with 60% detected at a late stage. Many patients do not
complete their cancer treatment; thus this complicates the management and
increases the need for more expensive but less effective treatment. The main
purpose for introducing the CCTI benefit is to encourage beneficiaries diagnosed
with cancer to comply and complete their treatment.

3.1.2 The Benefit

CCTI recipients will receive a total of RM 1000 for completing their cancer
treatment. The incentive is given in 2 stages and will be credited directly
into the beneficiary’s registered bank account:

a) First payment (RM 300) - upon successful application.

b) Second payment (RM 700) - upon completing cancer treatment, and
verified by the treating doctor

3.2 ELIGIBILITY

3.2.1 Prerequisite:

a) Open to all PeKa B40 beneficiaries

b) Application must be made by a treating doctor at Ministry of Health (MOH)
Hospital
c) Beneficiaries must complete the Health Screening under PeKa B40 scheme for
CCTI application to be approved.

3.2.2 Eligibility

a) The beneficiary has been diagnosed with any type of cancer as

confirmed by histopathological examination (HPE), radiological, and/or
blood investigations which includes:
• Newly diagnosed cancer
• Previously diagnosed cancer and still on treatment.
b) In the rare case where the beneficiary has more than one (1) type of
primary cancers, he/she will be eligible for CCTI for each of the cancer
diagnosed and treated*

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*For example, if the beneficiary has primary cancer of breast cancer and primary
cancer of thyroid, he/she is eligible to apply CCTI for each of the primary cancer and
receive a total of RM2000.

3.2.2 Exclusion

a) Cancer treatment completed

A beneficiary who was previously diagnosed with cancer and has completed
treatment (?active? and curative) is not eligible for this benefit.
b) Recurrence and metastases
A beneficiary who is diagnosed with recurrent or metastatic cancer, whom
CCTI has been given upon his/her primary diagnosis, is not eligible for a
second application
c) Provisional Diagnosis
A beneficiary with a provisional diagnosis awaiting HPE, radiological, and/or
blood investigations is not eligible for CCTI

3.3 AUTHORISED USERS FOR CCTI

As stated in Section 1.4, PIC must register their department staffs as “Authorised
Users”. However, for CCTI, there are three levels of Authorised Users as outlined
below.

a) Person In Charge (PIC)

• Each of the relevant Hospital Departments will have one PIC who will be
registered and serve as the ‘Primary Account Holder’ in the BMS for his/her
respective department. PIC of a clinical department must be a medical doctor
or specialist.
• They will be able to:
o Create and deactivate other account users
o Control who may have access to the system and register them as
‘Authorised Users’ (“Team Leads” or “Normal Users”) for the BMS.
o Verify that the beneficiary has completed cancer treatment
b) Team Leads
• Team Leads are the treating doctors for the particular department.
• They will be able to:
o Update medical information of the beneficiary in the BMS
o Verify that the beneficiary has completed cancer treatment
c) Normal Users
• Normal Users should be MOH staff whose main role is to update the
beneficiary’s upcoming appointment date.
• They may be nurses, administrative staff or any personnel as deemed fit by
the department.
• They will not be able to verify that the beneficiary has completed cancer
treatment
PeKa B40 Manual for MOH Hospital
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3.4 CCTI APPLICATION & FIRST PAYMENT OF THE INCENTIVE

3.4.1 Steps for Application of CCTI

In CCTI, the treating doctor is defined as the medical officer, the specialist or the
surgeon at MOH Hospitals, who evaluate signs and symptoms, diagnose cancer,
carry out relevant examinations, tests and medical procedures, advise on cancer
treatment options, monitor the progress of treatment and if necessary, refer the
beneficiary onwards to other medical disciplines or health professional for further
opinion.

CCTI application should be submitted by the treating doctor for eligible PeKa B40
beneficiaries. Below are the steps required for the CCTI application:

a) Prior to application, the treating doctor must be registered as the “Team Lead” to
the BMS by their department’s PIC.
b) Once logged in to the system, the doctor will be able to check whether the
beneficiary has fulfilled the prerequisites.
c) In cases where Health Screening was not done, the doctor has to advise the
beneficiary to do screening first at GPs, or the treating doctor him/herself to
undertake inpatient Health Assessment at the hospital, depending on the
beneficiary’s condition. Please refer to Section 5 on Health Assessment
d) The treating doctor must ensure that all of the required beneficiary’s information
as listed below are filled in before submitting the application.
• MRN
• Date of diagnosis
• Diagnosis
• Stage of cancer
• Type of treatment given
• Next appointment date

Please refer Appendix 6 for the application form

3.4.2 Mode of Payment and Turnaround Time

After CCTI application has been submitted, ProtectHealth will review and approve.
The first payment of incentive (i.e. RM300) will be made within 3 working days from
the date of successful application. If the beneficiary has not completed Health
Screening, there will be a notification informing that CCTI application will only be
processed and approved after beneficiaries' Health Screening data is entered into the
system.

Subsequently, the first payment will only be released within three (3) working days
after approval. Payments will be directly credited to the beneficiary’s registered bank
account.

PeKa B40 Manual for MOH Hospital

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3.5 TRANSPORT INCENTIVE AND FOLLOW UP MODULE

Beneficiaries who receive CCTI will also automatically receive Transport Incentive
with the condition that the beneficiary’s next appointment date is keyed into the
system during every follow-up visit. Please refer Section 4 for further details on
Transport Incentive.

3.6 SECOND PAYMENT OF THE INCENTIVE

3.6.1 Steps to Verify Completed Cancer Treatment to Allow Second Payment

For the second payment of CCTI (i.e. RM700) to be released, only treating doctor
has to verify in the BMS, as the steps below.

a) Notification will be emailed to the last treating doctor to remind the

doctor to verify in the BMS that
• 9 months of treatment duration has been completed by the
beneficiary, starting from the date of application; AND
• at least 2 visits have been made for treatment, inclusive of the first
visit at when the application was done.
a) The treating doctor must log into the BMS and verify in the system that
this beneficiary has indeed fulfilled the criteria above.

3.6.2 Exclusion from the Second Payment

a) Defaulted treatment
The beneficiary will not be paid the second payment if they fail to fulfil the criteria
above, as confirmed by the treating doctor.

b) Death
Upon death, the second payment will not be made as only the beneficiary is
allowed to receive the second payment.

3.6.3 Turnaround Time and Mode of Payment

The second payment of CCTI (i.e. RM700) should be made within three (3)
working days from the date of verification by the treating doctor

PeKa B40 Manual for MOH Hospital

Figure 4: CCTI Workflow Diagram

PeKa B40 Manual for MOH Hospital

4.1 ABOUT THE BENEFIT

4.1.1 Introduction

One of the reasons for delay or non-compliant to treatment and follow up is due to
transportation issues especially for those living in Sabah, Sarawak and the rural
areas of Peninsular Malaysia.

Transportation issues are even more challenging for individuals in the B40 or low-
income group population. Delay and non-compliance to treatment and follow ups will
worsen the patients' condition and eventually incur a higher treatment cost to the
government.

The main reason for introducing the Transport Incentive in PeKa B40 Scheme is to
provide some financial risk protection by providing aid for patients' transportation to
enable them to access healthcare. By aiding their transport to the hospital, their
financial burden can be lessened and their compliance to treatment can be
encouraged. The aim for transport incentive is to get patient to come for follow-
up/treatment.

4.1.2 Eligibility Criteria

To be eligible for Transport Incentive, patients must fulfill these criteria:

a) Patient is a recipient of PeKa B40 Health Aid benefit

• Diagnosed by a doctor to have a condition that needs the listed
health aid;
• Transport is needed to come for any procedure/surgery/follow up
related to Health Aid; AND/ OR
Patient is a recipient of Completing Cancer Treatment Incentive (CCTI)
• Diagnosed by a doctor to have any cancer (refer Section 3.2 for
further detail on CCTI eligibility);
• Transport is needed for patient to come for any cancer treatment as
approved by the treating doctor i.e. chemotherapy, radiotherapy,
surgery or any follow up related to cancer
b) Patient is treated at Ministry of Health (MOH) hospital
c) Patient has not exhausted the limit of RM500 for Peninsular Malaysia and
RM1000 for Sabah & Sarawak/ AND still have balance after previous
application of transport incentives

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4.1.3 Exclusion Criteria
Patients are not eligible for transport incentives in the following circumstances:

a) Patients attend follow up in hospitals BUT NOT related to health aid/

cancer treatment
b) Patients come to hospital for emergency treatment
c) Patients use transport provided by the MOH hospital/clinics
d) Patients transferred between public hospitals for upgrade/ downgrade of
treatment using public hospital’s ambulance
e) Patients attend follow up in primary care
f) Patients discharged themselves at their own risk (AOR)/ against medical
advice
g) Transport cost for other family members or care takers
h) Patient receive treatment related to health aid/ cancer treatment in
private hospitals/ Ministry of Defence hospitals/ university hospitals/
abroad.

4.1.4 Rate of Payment

The rate or payment for the transport incentive is RM 0.80 per kilometer. The
distance and amount for each payment will be auto-calculated by the BMS based on
the distance between beneficiary registered home address to the Hospital
where application is made.

4.1.5 Per diagnosis

Limit for RM500 for Peninsular and RM1000 for Sabah, Sarawak and Labuan
is for each diagnosis of health aid AND/ OR cancer

Example: If Encik Ali has prostate cancer and is receiving cancer treatment,
he is eligible for transport incentive (up to RM500 for Semenanjung) for his
cancer follow up. Encik Ali then involve in an accident and require health
aid. Then, he is also eligible for another transport incentive (up to RM500)
for his health aid follow up.

4.1.6 Responsible Staff for Transport Incentive

a) PIC should appoint at least one (1) staff at their department to be responsible for
applying the Transport Incentive (Responsible Staff).
b) Any request for Transport Incentive should be directed to the Responsible Staff
for Transport Incentive at each department
c) The responsible staff should be registered as Authorised User in order to be able
to access the online application module for Transport Incentive

PeKa B40 Manual for MOH Hospital

4.2.1 Step 1: Ensure Eligibility and Balance Availability for Transport Incentive

a) Once the responsible staff enter the beneficiary’s NRIC in the BMS, the
availability of transport incentive balance will be displayed

For CCTI recipients, beneficiaries do not need to request for transport

incentive as this will be automatically applied once the staff/ doctor enter the
next appointment date for cancer treatment in the BMS

4.2.2 Step 2: Online Application

a) The application must be done during the current follow up

b) For health aid recipients, if the balance is available, the staff can apply for the
transport incentive. The required information are:
• Next follow up date
• Department where beneficiary’s receiving treatment
c) Submit the application

4.3 PAYMENT

4.3.1 Payment Method

After the information required is entered into the BMS and submitted, the request will
be processed by BMS. Payment will be done via bank transfer to beneficiaries’
registered bank account.

4.3.2 Maximum Limit Per-Application

The transport incentive for the journey from patients' home to the hospital,
and then from hospital back to patient's home (to and fro journey) is
considered as one (1) application. The maximum limit for one (1) application
is as stated below:
a) Peninsular: RM 200 per-application
b) Sabah: RM 400 per-application

4.3.3 Review and Approval by ProtectHealth

All request will be reviewed by ProtectHealth and TAT for approval is within three (3)
working days from the date of application.

PeKa B40 Manual for MOH Hospital

a) First Transport Incentive

For the first application of transport incentive, beneficiaries will receive the total
amount for:
• Reimbursement of transport incentive for the journey to and fro on the day of
appointment where the first application made, and
• Transport incentive of the to and fro journey for the next appointment visit

b) Subsequent Transport Incentive (Advance Payment)

For the subsequent transport incentive applied, beneficiaries will receive
advance payment of Transport Incentive for travelling to and fro for the next
appointment visit.

The summary of first and subsequent Transport Incentive payments is illustrated

as in Figure 5 below.

Figure 5: Summary of First and Subsequent Transport Incentive Payments

4.3.5 Transport Incentive Inadequate

If the balance for transport incentive is available, but inadequate, the beneficiary will
receive only the balance available. For example, if the calculated rate for the
incentive is RM 150, but the balance is RM100, patient will only receive RM100.

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4.4 TRANSPORT INCENTIVE WORKFLOW DIAGRAM

Figure 6: Transport Incentive Workflow Diagram

PeKa B40 Manual for MOH Hospital

5.1 CRITERIA FOR HEALTH ASSESSMENT IN MOH HOSPITAL

Health Screening is a prerequisite for beneficiaries to access the other 3 benefits

under PeKa B40 Scheme. There are cases where beneficiaries are admitted in MOH
Hospital and they require Health Aid (HA) and/or the Completing Cancer Treatment
Incentive (CCTI) benefit, but they have not undergone screening yet. Under such
circumstances, Health Assessment at MOH Hospital can be done as an alternative.
However, all following criteria must be met in order to allow PeKa B40 Health
Assessment at MOH Hospital:
a) Beneficiaries are eligible for PeKa B40 Scheme
b) Have not undergone Health Screening at GP/KK
c) Require HA or CCTI benefit while admitted at MOH Hospital
d) Unable to be discharged from hospital

5.2 HEALTH ASSESSMENT COMPONENTS

a) Medical history taking (Refer Section 5.7.1)

• Past medical history
• Family history
• Social history
• Screening symptoms and risk factors for NCDs
• Screening symptoms for mental health (Refer Section 5.7.2)
b) Physical examination (Refer Section 5.7.3)
• Weight and height
• Blood pressure and pulse rate
• General and systemic examination
• Clinical breast examination (CBE)
• Digital rectal examination (DRE) if indicated
c) Taking blood and urine specimens for the following laboratory investigations
(Refer Section 5.9)
• Full blood count (FBC)
• Renal profile with estimated glomerular filtration rate (eGFR)
• Glycosylated haemoglobin A1c (HbA1c)
• Random lipid profile
• Urine biochemistry
d) Consultation on Health Assessment result
e) Referral (when indicated)

5.3 HEALTH ASSESSMENT PROCESS

5.3.1 Application for HA and/or CCTI can be done concurrently with Health Assessment.
However, the application for HA and/or CCTI will only be processed and approved
after the results of Health Assessment including laboratory results are entered into
BMS.
PeKa B40 Manual for MOH Hospital
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5.3.2 Steps for Health Assessment

a) Health Assessment for Health Aid (HA) Approval

• Treating doctor who has identified beneficiary requiring HA will refer the case
to MSW
• MSW key in beneficiary’s NRIC in BMS and check if beneficiary fulfil the
prerequisite criteria as in Section 2.2.1
• If beneficiaries have not done PeKa B40 Health Screening, MSW can still
proceed with the application
• There will be a notification informing that HA application will only be
processed and approved after beneficiaries' Health Screening/Assessment
data is entered into the system
• Till then, the status of HA application will be ‘pending for review’
• MSW must inform the treating doctor to complete the Health Assessment for
the HA application to be processed
• Before doing the Health Assessment, the treating doctor must request
beneficiary to sign Declaration and Consent Form for Personal Data.
(Appendix 7)
• Once the treating doctor has completed the Health Assessment as stated in
Section 5.2, the treating doctor/PIC in the respective department must enter
the information into the BMS.
• Treating doctor/PIC also need to update beneficiary’s information in the BMS
and upload required documents to complete the Health Assessment process.
• The HA application will then be reviewed by ProtectHealth. TAT for
processing of HA approval is as stated in Section 2.10

b) Health Assessment for CCTI Approval

• Treating doctor who has identified beneficiary requiring CCTI will check
beneficiary’s eligibility in the BMS
• If beneficiary is eligible for PeKa B40, treating doctor will proceed to CCTI
online application as in Section 3.4.1
• There will be a notification informing that CCTI application will only be
processed and approved after beneficiary’s Health Screening/Assessment
data is entered into the system
• Till then, the status of CCTI application will be ‘pending for review’
• Before doing the Health assessment, the treating doctor request beneficiary
to sign Declaration and Consent Form for Personal Data (Appendix 7)
• The treating doctor must complete all Health Assessment components as
stated in Section 5.2
• Once the treating doctor has completed the Health Assessment, the treating
doctor/PIC of the respective department must enter the information into the
BMS.
• Treating doctor/PIC also need update beneficiary’s information in the BMS
and upload required documents to complete the Health Assessment process.
• The CCTI application will then be review by ProtectHealth. The TAT for
processing of CCTI approval is as stated in Section 3.4.2
PeKa B40 Manual for MOH Hospital
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Treating doctor must complete Health Assessment and enter the
information into the system in order for HA/CCTI application to be
processed for approval

5.4 HOSPITAL RECORD

MOH Hospital shall maintain the record of every PeKa B40 beneficiary that has done
Health Assessment at hospital. The hospital’s record of the PeKa B40 beneficiary
should include (but is not limited to) the following:
a) Beneficiary name and NRIC
b) Date of Health Assessment
c) Declaration and Consent Form for Personal Data (Appendix 7)
d) Clinical history, physical examination, lab results, and referral letters
e) Any other relevant documents related to the PeKa B40 beneficiary

ProtectHealth reserves the right to review the hospital records of the PeKa B40
beneficiaries for medical audit including site review purposes.

5.5 BENEFICIARY CONSENT

Beneficiaries are required to read and understand the Declaration and Consent
Form for Personal Data (Appendix 7) which can be downloaded from the BMS.
The treating doctor must get the beneficiary’s signature for the consent before
undergoing Health Assessment.

A scanned copy of the signed Declaration and Consent Form must be

uploaded into the system as part of claims requirements
The original copy of the signed Declaration and Consent Form must be kept at the
hospital for 6 years.

5.6 UPDATING BENEFICIARY’S INFORMATION

5.6.1 Below are the required information to be updated:

a) Beneficiary name
b) Citizenship
c) Date of birth
d) Age
e) Sex
f) Ethnicity
g) Home address
h) Marital status
i) Occupation
j) Religion
k) Education level
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l) Email address
m) Beneficiary’s phone number
n) Preferred Methods of instant messaging application for beneficiary

5.6.2 Updating beneficiary’s information is required for the purpose of: -

a) Ensuring that beneficiaries are contactable
b) Risk profiling
c) Optimizing the provision of other benefits, such as Transport Incentive (Benefit 4)
which involves calculation of standard rates from beneficiaries’ home to MOH
hospitals

Please refer to Appendix 8: Update Beneficiary Information Form

5.7 HEALTH ASSESSMENT FORMAT

5.7.1 Structured Medical History Taking

The structure of the history taking process focuses on NCDs and risk assessment. To
ease data capture of the history taking process, the format of the health screening
questionnaire is prepared in a checklist manner to reduce free text entry as much as
possible. However, there are some areas of history where the doctor needs to
document in detail, for example, when there are abnormalities or positive medical
findings. Please refer to appendices 3 and 4 for further information on the Health
Screening module:
a) Appendix 9: Health Screening Form
b) Appendix 10: Physical Activity Guide

5.7.2 Screening Symptoms for Mental Health

Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-
7) Questionnaire are used to screen for possible mental health concerns. The
questionnaires are self-administered using a four-point Likert scale of frequency or
severity based on the beneficiary’s experiences over the last two weeks. If a
beneficiary is having difficulty in understanding or answering the questions, the
doctor is expected to provide assistance and to explain the questions. The doctor
must enter the responses into the BMS and the system will auto-populate the final
score. Please refer to the Screening Symptoms for Mental Health questionnaire as
in Appendix 11.

Beneficiaries who score 10 or above in either Questionnaire should be

referred

5.7.3 Physical Examination

The physical examination requirements are mostly prepared in a checklist format,
unless in the case of abnormalities, in which the doctor is required to explain in detail
the findings in the comments section. The treating doctor must counsel and obtain

PeKa B40 Manual for MOH Hospital

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Page | 34
consent from the beneficiary before performing CBE and DRE. Please refer to the
Physical Examination section of the Health Screening form as in Appendix 9.

5.8 PROVISIONAL DIAGNOSIS

Taking into consideration the findings from the history and physical examination, the
doctor may propose a provisional diagnosis for the beneficiary.

5.9 LABORATORY INVESTIGATIONS

The doctor will take an adequate volume of blood and urine from the beneficiaries for
the following investigations (Laboratory parameters as attached in Appendix 12);

a) Full blood count (FBC)

b) Glycosylated hemoglobin A1C (HbA1C)
c) Random lipid profile
d) Renal profile (RP) with estimated glomerular filtration rate (eGFR)
e) Urine Biochemistry

For Health Assessment, the doctor will use existing hospital pathology services in
MOH Hospital and existing hospital laboratory request form.

Laboratory results must be reviewed, and a scanned copy of the laboratory

results must be uploaded in the system

5.10 CONSULTATION AND REFERRAL

Following health assessment, consultation will be given to beneficiary and referral will
be made if indicated.

5.11 ENTERING HEALTH ASSESSMENT DETAILS INTO BMS

PIC is responsible to make sure the screening information is entered into

BMS after all the Health Assessment components are completed within 10
days from date of the Health Assessment.

5.11.1 Documents to be Uploaded in BMS for Health Assessment Completion

a) Declaration and Consent Form for Personal Data
b) Laboratory results

5.11.2 Once the Health Assessment details are entered and documents uploaded, the
Screening Summary can be generated from BMS. This Screening Summary can be
printed to be given to beneficiary.

PeKa B40 Manual for MOH Hospital

Figure 7: Health Assessment Workflow

PeKa B40 Manual for MOH Hospital

6.1 INTRODUCTION

The pathway for PeKa B40 Health Screening is through registered PeKa B40
General Practitioner (GP) or Klinik Kesihatan (KK). Following Health Screening,
GP/KK may refer cases (if indicated) to MOH Hospital. PeKa B40 beneficiaries
referred from PeKa B40 Health Screening are identified by PeKa B40 Referral Letter
as shown in Appendix 13.

PeKa B40 referrals must be monitored to enable MOH to take appropriate

measures in relation to the increased workload and capturing beneficiaries
who default referral

PeKa B40 beneficiaries is waived from first class charges following private referral.
The Official Letter for Approval of the 1st Class Waiver Charges is as attached in
Appendix 14.

6.2 UPDATING REFERRAL WORKFLOW

Updating of referral cases should be done at least on a weekly basis by the

staff at the department receiving the referral.

The workflow for updating referral cases is illustrated in the Figure 8.

PeKa B40 Manual for MOH Hospital

Beneficiary arrives at MOH Hospital with PeKa B40

referral letter from GP/KK

PeKa B40 beneficiary is

Staff at registration counter receives PeKa B40 st
waived from 1 class
Referral Letter and inform PIC charges following
private referral
PIC at respective department go to BMS website:
https://bms.pekab40.com.my/site/login
✓ Go to update referred case page
✓ Key in beneficiary’s NRIC number and date of
attendance
✓ Click submit

Follow existing process for referral cases at KK/MOH

Hospital

END

Figure 8: Updating Referral Workflow

PeKa B40 Manual for MOH Hospital

List of Appendices

Appendix 1 : Form C (Borang C)

Appendix 2 : Rejection Letter
Appendix 3 : Co-Payment Letter
Appendix 4 : Letter of Award
Appendix 5 : Consignment Note
Appendix 6 : Completing Cancer Treatment Incentive (CCTI) and Transport
Incentive for Cancer Patients Application Form
Appendix 7 : Declaration and Consent Form for Personal Data
• Malay Version
• English Version
• Chinese Version
• Tamil Version
Appendix 8 : Update Information Form
Appendix 9 : Health Screening Form
• First Visit Screening Form
• Second Visit Screening Form
Appendix 10 : Physical Activity Guide
Appendix 11 : Mental Health Symptoms Screening Questionnaire
• Malay Version
• English Version
• Chinese Version
• Tamil Version
Appendix 12 : Laboratory Investigation Parameters
Appendix 13 : Referral Letter
Appendix 14 : Official Letter for Approval of 1st Class Charges Waiver

PeKa B40 Manual for MOH Hospital

Copyright © 2019 ProtectHealth Corporation Sdn. Bhd
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Page | 39
BORANG C
APPENDIX 1
LAPORAN PEGAWAI PERUBATAN/PAKAR
PERMOHONAN TABUNG BANTUAN PERU BATAN

NAMA PESAKIT

NO. K/P

NO. RUJUKAN HOSPITAL:

JABATAN KEPAKARAN:

Jenis Penyakit (Diagnosis)

Latar belakang penyakit dan rawatan

Peralatan / Ubat yang diperlukan:

Jangkamasa rawatan dengan menggunakan peralatan/ ubat yang diperlukan:

(minggu/bulan/ sepanjang hayat). Sebab

peralatan/ubat itu diperlukan:

Aggaran kos bagi rawatan /ubat / alatan perubatan*

(* Bersama-sama ml disertakan sebutharga dan syarikat pembekal)

Kekerapan penhlalan semula (review) ialah (minggu/ bulan/

tahun).

Page 1 of2
BORANG C

Prognosis:

Lain-lain makiumat yang berkaitan

Sekiranya terdapat pertanyaan, Unit mi boteh dihubungi di talian

Perakuan Pegawai /Pakar Perubatan Pengesahan Ketua Jabatan

(Tandatangan) (Tandatangan)

Nama : Nama Ketua Jabatan:

Cop Rasmi : Cop Rasmi

Tarikh : Tarikh:
* Sila potong yang tidak berkenaan

** Sila sertakan lampiran, jika ruang tidak mencukupi

Page 2 of 2
APPENDIX 2

ProtectHealth Corporation Sdn Bhd

F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan,
63000 Cyberjaya, Selangor
No Tel : 03-8687 2500
No Faks : 03-8687 2599

SURAT PENOLAKAN
Rujukan :
Tarikh :

SULIT

Tuan/ Puan,

Surat Penolakan Bantuan Alat Perubatan bagi Peduli Kesihatan (PeKa) B40
Nama:
Kad Pengenalan:

Dengan hormatnya perkara di atas adalah dirujuk.

2. Dukacita dimaklumkan bahawa permohonan anda bagi bantuan alat perubatan XXX
berjumlah RM XXX di bawah Peduli Kesihatan (PeKa) B40 telah ditolak.

3. Penolakan ini adalah disebabkan oleh:

Peralatan yang dipohon tidak termasuk di dalam senarai

Had seumur hidup Bantuan Alat Perubatan telah habis digunakan
Tidak bersetuju untuk pembayaran bersama (co-payment)
Lain-lain. Nyatakan……………………….

Sekian, terima kasih.

“LEBIH PEKA LEBIH CAKNA”

Ketua Pegawai Eksekutif

ProtectHealth Corporation Sdn. Bhd. (Company No. 1212734-T)
(Surat ini adalah cetakan komputer dan tidak memerlukan tandatangan)
APPENDIX 3

ProtectHealth Corporation Sdn Bhd

F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan,
63000 Cyberjaya, Selangor
No Tel : 03-8687 2500
No Faks : 03-8687 2599

SURAT TAWARAN PEMBAYARAN BERSAMA (CO-PAYMENT)

Rujukan :
Tarikh :
SULIT

Tuan/ Puan,

Surat Setuju Terima Tawaran Pembayaran Bersama Bantuan Alat Perubatan bagi
Peduli Kesihatan Untuk Kumpulan B40 (PeKa B40)
Nama:
Kad Pengenalan:

Dengan hormatnya perkara di atas adalah dirujuk.

2. Adalah dimaklumkan bahawa permohonan Tuan/Puan bagi Bantuan Alat Perubatan

di bawah PeKa B40 iaitu XXX yang berjumlah RMXXX tidak dapat diproses selanjutnya
kerana baki Bantuan Alat Perubatan tidak mencukupi/ melebihi julat harga.

3. Walau bagaimanapun sekiranya pihak Tuan/Puan dapat menyumbangkan

pembayaran berjumlah RMXXX permohonan ini akan diproses.

Sekian, terima kasih.

“LEBIH PEKA LEBIH CAKNA”

Ketua Pegawai Eksekutif

ProtectHealth Corporation Sdn. Bhd. (Company No. 1212734-T)

(Surat ini adalah cetakan komputer dan tidak memerlukan tandatangan)

ProtectHealth Corporation Sdn Bhd
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan,
63000 Cyberjaya, Selangor
No Tel : 03-8687 2500
No Faks : 03-8687 2599

SURAT SETUJU TERIMA TAWARAN PEMBAYARAN BERSAMA (CO-PAYMENT)

Rujukan :
Tarikh :
SULIT

ProtectHealth Corporation Sdn Bhd,

Century Square, F01 & F02, 1st Floor, Block 2300,
Jalan Usahawan, 63000 Cyberjaya, Selangor.

Surat Tawaran Pembayaran Bersama (Co-Payment) Bantuan Alat Perubatan bagi Peduli
Kesihatan untuk Kumpulan B40 (PeKa B40)
Nama:
Kad Pengenalan:

Merujuk kepada surat Tuan dengan nombor rujukan……………. bertarikh …. dengan

hormatnya perkara di atas adalah dirujuk.

2. Adalah dimaklumkan setelah meneliti tawaran di atas, saya dengan ini BERSETUJU/
TIDAK BERSETUJU membayar sebanyak RM…… untuk tawaran alat bantuan perubatan
……………. yang berjumlah RM…………..

3. Saya ambil maklum bahawa pembayaran perlu dijelaskan sebelum pihak pembekal
membekalkan alat perubatan berkenaan.

Sekian Terima Kasih,

__________________________ _______________________________
Tandatangan Pesakit/ Waris Pesakit Tandatangan Saksi
Nama: Nama:
No Kad Pengenalan: No Kad Pengenalan:
APPENDIX 4

ProtectHealth Corporation Sdn Bhd

F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan,
63000 Cyberjaya, Selangor
No Tel : 03-8687 2500
No Faks : 03-8687 2599

LETTER OF AWARD
Ref No:
Date:

CONFIDENTIAL

Vendor’s Name
(Address_____________)
(Attention: XXX )

Dear Sir/ Madam,

LETTER OF AWARD FOR SUPPLYING HEALTH AID UNDER SKIM PEDULI KESIHATAN
BAGI KUMPULAN B40 (PeKa B40) (HEREINAFTER REFERRED TO AS “LETTER”)
Beneficiary Name:
NRIC No:

Reference is made to the above.

2. ProtectHealth Corporation Sdn Bhd (“ProtectHealth”) is pleased to inform you that the
above beneficiary’s application for the XXX (health aid) under the PeKa B40 has been
approved for RM XXXX. Please note that there will be a copayment from beneficiary for an
amount of RM XXX

3. The validity period of this Letter shall be within 6 months / 1 year from the date hereof
(hereinafter referred to as “the Term”). Upon the expiring of the said Term, this Letter shall be
lapsed and/or annulled.

4. Kindly liaise with the attending doctor and beneficiary for verification process. You are
advised to submit consignment note and invoice within one (1) month from the date of
surgery or delivery of the health item. ProtectHealth shall not be liable for the failure of your
documentation submission to ProtectHealth, upon the expiry of the stipulated dateline.

5. You shall undertake to indemnify, defend and hold harmless ProtectHealth from and
against any claim in respect of loss, damage, liabilities, fines, penalties, forfeitures, suits and
the costs and expenses incidental thereto, arising from damage to life or bodily injury or real
or tangible personal property or violation of governmental laws, regulations or orders, caused
in whole or in part, by your organization’s misrepresentation or breach of any warranty, term
or provision of the Letter of Award; or any negligent or wilful act or omission on your

Page 1 of 3
organization’s part, its employees and/or agents while engaged in the performance of the
Services.

6. Your cooperation and assistance are highly appreciated.

Thank you.

“LEBIH PEKA LEBIH CAKNA”

DATUK HJ AB LATIFF HJ ABU BAKAR

Chief Executive Officer
ProtectHealth Corporation Sdn. Bhd.

c.c:
Hospital director
Hospital XXX
Jalan XXX
Postcode
State
(att: Social Worker’s name)

Head of XXX department

Hospital XXX
Jalan XXX
Postcode
State
(att: Dr ABC)

Patient’s name and address

ProtectHealth Corporation Sdn Bhd
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan,
63000 Cyberjaya, Selangor
No Tel : 03-8687 2500
No Faks : 03-8687 2599

Date: XX April 2019

ACKNOWLEDGEMENT RECEIPT OF THE LETTER OF AWARD BY THE COMPANY

It is hereby confirmed that the undersigned below acknowledge receipt of this Letter dated XX
March 2019 (Ref No: ______________). Thus, hereby agrees with the terms and conditions
contained in this Letter unconditionally where a copy of this Letter has been retained, and it is
further reconfirmed that no terms, conditions or additional stipulations other than those
contained in the quotation document and this Letter have been imposed.

…………………………………..
Signature by the Company
Full Name :
I/C Number :
Address :
Date :

Company’s seal or stamp

Page 3 of 3
APPENDIX 5

ProtectHealth Corporation Sdn Bhd

F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan,
63000 Cyberjaya, Selangor
No Tel : 03-8687 2500
No Faks : 03-8687 2599

CONSIGNMENT NOTE

Letter of Confirmation of Health Aid To Beneficiaries

Under the PeKa B40 Scheme

1. I certify that treatment / health aid to the patients below have been executed based on the
approval letter from the Protecthealth Corporation Sdn Bhd
No. reference (autogenerate) dated (autogenerate)
The health aid supplies details are as follows: -

1.1 Patient Name : (autogenerate)

1.2 NRIC number : (autogenerate)
1.3 Type of Treatment : (autogenerate)
1.4 Actual Health Aid Cost : RM (autogenerate)
1.5 Approved Health Aid Cost : RM (autogenerate)
1.6 Date Received Item : _______________ (for Non-Surgical Item)
1.7 Date of Surgery : _______________ (for Surgical Item)
1.8 Place of Treatment : (autogenerate)

2. Included original copy of invoice from Company __________

Invoice number _____________ Dated _____________
The claim charged RM (______________) as the person who has supplied the health aid.

*notes

Certified by Verified by Head of Department

Name Name
Position Position
IC no IC no
Official stamp Official stamp
MMC/Valid APC MMC/Valid APC
Date Date
Note; can be certified by treating/referring * confirmed if there is a difference in the
Doctor or Medical Social Worker amount of approval with the invoice / treatment
made prior to approval or others
APPENDIX 6
PEKAB40/CCTI/2019/01

ProtectHealth Corporation Sdn Bhd

(1212734 -T}
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan
63000 CyberJaya, Selangor
T +603 8687 2500
F +603 8687 2599
Peduli Kesihatan untuk Kumpulan B40 E [email protected]
Completing Cancer Treatment Incentive www.protecthealth.com.my

Completing Cancer Treatment Incentive (CCTI) and Transport Incentive for Cancer Patients

INSTRUCTION: Where checkboxes () are provided, check () one or more boxes. Where radio buttons () are provided, select
() one option only.

New IC number - -

Full name

Sex  Female  Male

Date of visit/application D D - M M - Y Y Y Y

Medical registration number (MRN)

Section A: Cancer Diagnosis

Any change in diagnosis?  Yes, reason for change

Note: For new application, select “Not applicable”
 No  Not applicable

Date of diagnosis D D - M M - Y Y Y Y

Diagnosis Diagnosis

ICD-10 code
Stages of cancer TNM staging T N M
 Not applicable

Cancer stage  Stage I  Stage III  Unknown

 Stage II  Stage IV

Section B: Treatment Plan

Any change in treatment plan?  Yes, reason for change

Note: For new application, select “Not applicable”
 No  Not applicable

Type of treatment Start date Administered in current visit

 Surgery D D - M M - Y Y Y Y 

 Chemotherapy D D - M M - Y Y Y Y 

 Radiotherapy D D - M M - Y Y Y Y 

 Hormonal drug therapy D D - M M - Y Y Y Y 

 Other, please specify

D D - M M - Y Y Y Y 

Next appointment date D D - M M - Y Y Y Y

Treating doctor Full name

MMC registration number

Designation  Specialist  Medical Officer

Hospital Department
APPENDIX 7:
Declaration and Consent Form for Personal Data

• Malay version
• English version
• Chinese version
• Tamil version
ProtectHealth Corporation Sdn Bhd
(1212734 -T}
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan
63000 CyberJaya, Selangor
T +603 8687 2500
F +603 8687 2599
Peduli Kesihatan untuk Kumpulan B40 E [email protected]
Consent and Declaration Form www.protecthealth.com.my

PERSETUJUAN DAN DEKLARASI BAGI TUJUAN DATA PERIBADI

1. KLAUSA PERSETUJUAN

Dengan menandatangani dan mengemukakan borang ini, saya akui bahawa saya telah membaca, memahami,
dan bersetuju dengan terma-terma Dasar Privasi ProtectHealth Corporation Sdn Bhd ("ProtectHealth"). Saya
dengan sukarela mengizinkan dan memberi kuasa kepada ProtectHealth bagi mengumpul, mentadbir,
mengurus, dan memproses semua data peribadi saya termasuk data peribadi sensitif (dikenali sebagai "Data
Peribadi") untuk digunakan hanya untuk tujuan yang berkaitan dengan Skim Peduli Kesihatan untuk Kumpulan
B40 (secara kolektif dikenali sebagai "PeKa B40") termasuk yang berikut:-

• Saringan Kesihatan;
• Bantuan Alat Perubatan;
• Insentif Melengkapkan Rawatan Kanser;
• Insentif Tambang Pengangkutan;
• Audit Perubatan dan Kualiti;
• Profil Kesihatan;
• Analsis data; dan
• Pemantauan dan Penilaian;

secara kolektif dikenali sebagai "Tujuan".

1.1. Saya juga membenarkan ProtectHealth untuk: -

a. mengumpul, mentadbir, mengurus, dan memproses Data Peribadi saya (termasuk data peribadi
sensitif) yang diperolehi secara langsung atau tidak langsung daripada pihak ketiga, pengamal
perubatan berdaftar, klinik-klinik, hospital-hospital, makmal-makmal, lain-lain fasiliti kesihatan yang
relevan, dan/atau Kementerian Kesihatan Malaysia;
b. berkongsi data peribadi saya dengan Kementerian Kesihatan Malaysia, jika perlu.

1.2. Bagi mengelakkan keraguan, Data Peribadi merangkumi semua data yang ditakrifkan di dalam Akta
Perlindungan Data Peribadi 2010 ("APDP").

2. DEKLARASI

2.1. Saya mengakui dan mengesahkan bahawa saya telah membaca, memahami dan bersetuju untuk
tertakluk dengan terma-terma Dasar Privasi ProtectHealth.

2.2. Saya mengesahkan dan mengisytiharkan bahawa data dan maklumat peribadi saya yang saya berikan
kepada ProtectHealth adalah benar dan betul berdasarkan pengetahuan saya.

2.3. Saya akan maklumkan kepada ProtectHealth dengan serta-merta mengenai apa-apa perubahan
kepada data peribadi saya.

____________________
Tandatangan
Nama :
No Kad Pengenalan :
Tarikh :
ProtectHealth Corporation Sdn Bhd
(1212734 -T}
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan
63000 CyberJaya, Selangor
T +603 8687 2500
F +603 8687 2599
Peduli Kesihatan untuk Kumpulan B40 E [email protected]
Consent and Declaration Form www.protecthealth.com.my

CONSENT AND DECLARATION FOR PERSONAL DATA

1. CONSENT CLAUSE

By signing and submitting this form, I am declaring that I have read, understand, and agree to the terms of the
Privacy Policy of ProtectHealth Corporation Sdn Bhd (“ProtectHealth”). I voluntarily consent and authorise
ProtectHealth to collect, administer, manage, and process all my personal data including sensitive personal data,
(collectively known as “Personal Data”) to be used only for the purposes related to Skim Peduli Kesihatan untuk
Kumpulan B40 (known as “PeKa B40”), including the following: -

• Health Screening;
• Health Equipment Aid;
• Completing Cancer Treatment Incentive;
• Transport Incentive;
• Medical Audit and Quality;
• Health Profiling;
• Data Analytics; and
• Monitoring and Evaluation;

collectively known as “the Purposes”.

1.1. I also consent for ProtectHealth to: -

a. collect, administer, manage, and process my Personal Data (including sensitive personal data)
obtained directly or indirectly from third parties, registered medical practitioners, clinics, hospitals,
laboratories, other relevant healthcare facilities and/or the Ministry of Health Malaysia;
b. disclose my personal data to the Ministry of Health Malaysia, if necessary.

1.2. For avoidance of doubt, Personal Data includes all data defined within the Personal Data Protection Act
2010 (“PDPA”).

2. DECLARATION

2.1. I acknowledge and confirm that I have read and understand the Privacy Policy of ProtectHealth.

2.2. I confirm and declare that my personal data and information disclosed to ProtectHealth are true and
correct to the best of my knowledge.

2.3. I undertake to inform ProtectHealth immediately on any changes of my personal data.

____________________
Signature
Name :
NRIC No :
Date :
ProtectHealth Corporation Sdn Bhd
(1212734 -T}
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan
63000 CyberJaya, Selangor
T +603 8687 2500
F +603 8687 2599
Peduli Kesihatan untuk Kumpulan B40 E [email protected]
Consent and Declaration Form www.protecthealth.com.my

個人資料收集同意書及聲明

1. 同意條款

通過簽署並提交此表格，我宣佈我理解並同意 ProtectHealth Corporation Sdn Bhd（“ProtectHealth”）隱私政策的

條款。我自願同意並授權 ProtectHealth 收集、管理和處理我的所有個人資料（包括敏感的個人資料，統稱為“個
人資料”）。此授權僅限於與 Skim Peduli Kesihatan untuk Kumpulan B40（稱作“PeKa B40”）相關的目的，包括：
• 免費健康檢查；
• 醫療器材及配備援助；
• 完成癌症治療獎勵；
• 交通補貼；
• 醫療審計及質量；
• 健康狀況；
• 資料分析; 及
• 監測與評估；

統稱為“目的”。

1.1. 我也同意 ProtectHealth： -

a. 收集，管理和處理從選定的協力廠商、參與此計劃的全科醫生、診所、醫院、實驗室、其他相關醫
療機構及馬來西亞衛生部直接或間接獲得的個人資料（包括敏感個人資料）;
b. 如有需要的話，向馬來西亞衛生部披露我的個人資料。

1.2. 為避免疑義，個人資料包括 2010 年“個人資料保護法”（“PDPA”）中定義的所有資料，包括我在本表格中

向 ProtectHealth 提供的所有資料。

2. 聲明

2.1. 我承認並確認我已閱讀並理解 ProtectHealth 的隱私政策。

2.2. 我確認並聲明我向 ProtectHealth 提供的個人資料及資訊是真實和正確的。

2.3. 我承諾在我的個人資料有異動變更時，立即通知 ProtectHealth。

___________________________
簽名
姓名：
身份證號碼：
日期：年月日
ProtectHealth Corporation Sdn Bhd
(1212734 -T}
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan
63000 CyberJaya, Selangor
T +603 8687 2500
F +603 8687 2599
Peduli Kesihatan untuk Kumpulan B40 E [email protected]
Consent and Declaration Form www.protecthealth.com.my

தனிப்பட்ட தரவுக்கான இசைவு மற்றும் ைாற்றுதல்

1. இசைவுக்கூறு

இந்தப் படிவத்தில் கைய ொப்பமிட்டு ஒப்பகைப்பதின் மூலம், நொன் ப்ர ொயதக்ட் யெல்த்
ைொர்ப்பர ஷன் யெண்டிரி ொன் யபர்ெொட் / ProtectHealth Corporation Sdn. Bhd. (ப்ர ொயதக்ட்
யெல்த் / ProtectHealth) - இன் தனியுரிகமக் யைொள்கை ின் விதிைகைப் புரிந்துயைொண்டு
ஒப்புக்யைொள்ைிரேன் எனச் ெொற்றுைிரேன். என் அகனத்து தனிப்பட்ை த கவ (முைகம ொன
தனிப்பட்ை த வு உட்பை, யமொத்தமொை தனிப்பட்ை த வு என அேி ப்படும்) B40 பி40
பிரிவுக்ைொன யபடுலி யைெிெொட்ைொன் / Skim Peduli Kesihatan untuk Kumpulan B40 (யபைொ B40 /
PeKa B40) என அேி ப்படும்) நலத்திட்ைதிற்குத் யதொைர்பொன ரநொக்ைங்ைளுக்ைொை மட்டுரம
ரெைரிக்ை, நிர்வைிக்ை, ரமலொண்கம மற்றும் யெ லொக்ைம் யெய் ப் ப ன்படுத்த
தன்விருப்பத்துைன் இகெகவயும் அதிைொ த்கதயும் பின்வருவனவற்றுக்கு உட்பை
ப்ர ொயதக்ட் யெல்த்திற்கு வழங்குைிரேன்:

• சுைொதொ ப் பரிரெொதகன;
• சுைொதொ உதவி; மருத்துவ ெொதன உதவிைள்;
• புற்றுரநொய் ெிைிச்கெ ஊக்ைத்யதொகை நிகேவகைதல்; புற்றுரநொய் ெிைிச்கெ
முழுகம கைவதற்ைொன ஊக்ைத்யதொகை;
• ரபொக்குவ த்து ஊக்ைத்யதொகை;
• மருத்துவத் தணிக்கை (audit) மற்றும் த ம் (quality);
• சுைொதொ விவ க் குேிப்புைள்;
• த வு பகுப்பொய்வு, அேிக்கை மற்றும் யவைி டு
ீ ; மற்றும்
• ைண்ைொணிப்பு மற்றும் மதிப்பீடு;

ஒட்டுயமொத்தமொை, "ந ாக்கங்கள்" என்று அகழக்ைப்படுைிேது.

1.1. நொன் ப்ர ொயதக்ட் யெல்த்துக்கு (“ProtectHealth”) இகெவு அைித்த மற்ேகவ வருமொறு:-

a. ரதர்ந்யதடுக்ைப்பட்ை மூன்ேொம் த ப்பினர், பதிவு யெய் ப்பட்ை யபொது தனி ொர்

மருத்துவர்ைள், மருத்துவைங்ைள், மருத்துவமகனைள், ஆய்வுக்கூைங்ைள், பிே
யதொைர்புகை சுைொதொ வெதிைள் மற்றும் / அல்லது சுைொதொ அகமச்சு
ஆைி வற்ேிலிருந்து ரந டி ொைரவொ அல்லது மகேமுைமொைரவொ யபேப்பட்ை,
தனிப்பட்ை த கவ (முைகம ொன தனிப்பட்ை த வு உட்பை) ரெைரித்தல்,
நிர்வைித்தல், ரமலொண்கம மற்றும் யெ லொக்குதல்;
b. எனது தனிப்பட்ை த கவ சுைொதொ அகமச்சுக்கு யவைிப்படுத்துதல்.
1.2. ஐ த்கதத் தவிர்ப்பதற்ைொை, இந்தப் படிவத்தில் ப்ர ொயதக்ட் யெல்த்துக்கு
(“ProtectHealth”) நொன் யதரிவித்த அகனத்துத் த வுைளும், தனிப்பட்ை த வுப் பொதுைொப்புச்
ெட்ைம் 2010 (“PDPA”) இல் வக றுக்ைப்பட்ை அகனத்துத் த கவயும் உள்ைைக்ைி து.

2. ைாற்றுதல்

2.1. ப்ர ொயதக்ட் யெல்த்தின் (“ProtectHealth”) தனியுரிகமக் யைொள்கைக நொன் படித்துப்

புரிந்து யைொள்ைிரேன் என்பகத ஒப்புக்யைொண்டு உறுதி யெய்ைிரேன்.

2.2. நொன் ப்ர ொயதக்ட் யெல்த்துக்கு (“ProtectHealth”) யவைிப்படுத்தி எனது தனிப்பட்ை

த வுைள் மற்றும் தைவல்ைள் என் அேிவுக்கு எட்டி வக உண்கம மற்றும் ெரி ொனது
என்பகத உறுதியுைன் ெொற்றுைிரேன்.

2.3. என் தனிப்பட்ை த வில் ஏரதனும் மொற்ேங்ைள் இருப்பின், உைனடி ொை ப்ர ொயதக்ட்
யெல்த்துக்கு (“ProtectHealth”) யதரிவிக்கும் யபொறுப்கப ரமற்யைொள்ரவன்.

______________________________________
கைய ொப்பம்
யப ர் :
அகை ொை அட்கை எண் :
ரததி :
APPENDIX 8
PEKAB40/HS/UI/2019/01

ProtectHealth Corporation Sdn Bhd

Update Beneficiary Information

Section A: Demographic Information
Citizenship  Citizen  Permanent resident  Non-resident

New IC number - -

Full name

Date of birth D D - M M - Y Y Y Y Sex  Male  Female

Ethnic  Malay  Chinese  Indian/Punjabi

 Indigenous Sabah, please specify: __________________________________
 Indigenous Sarawak, please specify: ________________________________
 Orang Asli (Peninsular)  Other
Religion  Islam  Hindu  Other
 Christian  Sikhism  No religion
 Buddha  Taoism
Marital status  Never married  Widowed  Separated
 Currently married  Divorced
Highest level of education  No formal schooling
 Pre-primary education
 Primary education (Standard 1–6/UPSR)
 Lower secondary education (Remove class to Form 3/PMR/SRP/LCE/III Thanawi)
 Upper secondary education (Form 4–5/SPM/MCE/SPMV/IV Thanawi)
 Pre-university education (Form 6/Matriculation/STP/HSC/STPM/V Thanawi [STA/STAM])
 Certificate from college/polytechnic/university
 Diploma from college/polytechnic/university
 Bachelor's degree/postgraduate diploma
 Master's degree
 Doctoral degree
Work status  Government employee  Retired
 Semi-government employee  Homemaker
 Private company employee  Student
 Self-employed  Unemployed (able to work)
 Non-paid  Unemployed (unable to work)
Section B: Contact Information
Address 1
Address 2
Address 3
Postcode Town/city
State District
Landline number 1 Landline number 2
Mobile phone number 1
 WhatsApp  WeChat
 Facebook Messenger  None of the above
Mobile phone number 2
 WhatsApp  WeChat
 Facebook Messenger  None of the above
Email
Language choice for PeKa B40 messages  Melayu  English  中文  தமிழ்

Page 1 of 1
APPENDIX 9:
Health Screening Form
• First Visit Screening Form
• Second Visit Screening Form
PEKAB40/HS/HE/2019/01

ProtectHealth Corporation Sdn Bhd

History Taking and Physical Examination

INSTRUCTION: Where checkboxes () are provided, check () one or more boxes. Where radio buttons () are provided,
select () one option only.

New IC number - -

Full name
Sex  Female  Male

Date of examination D D - M M - Y Y Y Y

Section C: Medical History

Have you ever been told by a doctor or other
Currently
health professional that you have any of the Disease duration
being treated
following conditions?

 Diabetes mellitus years months  Don't know/remember  Yes  No

 Hypertension years months  Don't know/remember  Yes  No

 Hypercholesterolemia years months  Don't know/remember  Yes  No

 Coronary heart disease years months  Don't know/remember  Yes  No

 Stroke years months  Don't know/remember  Yes  No

 Chronic kidney disease years months  Don't know/remember  Yes  No

 Breast cancer years months  Don't know/remember  Yes  No

 Colorectal cancer years months  Don't know/remember  Yes  No

 Lung cancer years months  Don't know/remember  Yes  No

 Asthma years months  Don't know/remember  Yes  No

 Epilepsy or fits years months  Don't know/remember  Yes  No

 Mental illness years months  Don't know/remember  Yes  No

 Other, please specify years months  Don't know/remember  Yes  No

 None of the above

Section D: Family History

Do your immediate family members (parents, children and siblings) have any of the following conditions?
 Diabetes mellitus  Breast cancer
 Hypertension  Colorectal cancer
 Hypercholesterolemia  Lung cancer
 Coronary heart disease  Mental illness
 Stroke  Sudden death
 Chronic kidney disease  Other, please specify: _______________________________
 None of the above

Page 1 of 4
PEKAB40/HS/HE/2019/01
Section E: Behavioural Risk Factors
Tobacco Use
Do you currently smoke any tobacco products (such as cigarettes or vapes)?  Yes, daily
 Yes, less than daily
 No, I have stopped smoking
 No, I have never smoked tobacco
[“Daily” smoker only] On average, how many cigarettes or vapes do you smoke
per day
each day?
[“Less than daily” smoker only] On average, how many cigarettes or vapes do
per week
you smoke each week?
Alcohol Consumption
Have you ever consumed any alcohol (such as beer, wine, alcoholic herbal  Yes
beverages, todhi, samsu, tuak, or stout)?  No
[Drinker only] During the past 12 months, how frequently have you had at  Never
least one standard alcoholic drink?  Once a month or less
 2-4 times a month
 2-3 times a week
 4 or more times a week
[Drinker only] How often do you have six or more standard drinks in a single  Never
drinking occasion?  Less than once a month
 Monthly
 Weekly
 Daily or almost daily
Physical Activity
Vigorous activity In a typical week, on how many days do
you do vigorous-intensity activities at work
days per week
and during leisure time for AT LEAST 10
Examples:
MINUTES CONTINUOUSLY?
• carrying or lifting heavy loads
• digging or construction work How much time do you spend doing
• aerobic exercise vigorous-intensity activities on one of hours minutes per day
• fast cycling those days?
• playing football  No vigorous-intensity activities
Moderate activity In a typical week, on how many days do
you do moderate-intensity activities at
days per week
work and during leisure time for AT LEAST
Examples:
10 MINUTES CONTINUOUSLY?
• carrying light loads
• brisk walking How much time do you spend doing
• cycling at normal speeds moderate-intensity activities on one of hours minutes per day
• swimming those days?
• playing volleyball
 No moderate-intensity activities
• mopping the floor
Walking In a typical week, on how many days do
you walk for AT LEAST 10 MINUTES days per week
CONTINUOUSLY?
How much time do you spend walking on
hours minutes per day
one of those days?
 No walking
Sedentary Behaviour On a typical day, how much time do you
usually spend sitting or reclining at work,
hours minutes per day
at home, travelling, or with friends, BUT
NOT INCLUDING time spent sleeping?

Page 2 of 4
PEKAB40/HS/HE/2019/01
Section F: Physical Examination

New IC number - -
Chaperone
Full name

Height cm Blood pressure Systolic / Diastolic mmHg

Weight kg Pulse rate beats/min

Body mass index (BMI) kg/m2 Pulse rhythm  Regular  Irregular

Normal Abnormal Remarks (Mandatory if “Abnormal”)

General appearance

 

Head & neck

(including eyes, ears, nose, and throat)
 

Lungs

 

Heart

 

Abdomen

 

Back & extremities

 

Neurological

 

Section G: Digital Rectal Examination

Indications [For males ONLY] [Both females and males]
Please proceed to perform digital  Nocturia  Abdominal pain
rectal examination and refer  Difficulty starting urination (hesitancy)  Change in bowel habit
beneficiary for further investigation
 Weak flow or poor stream  Rectal bleeding
based on clinical judgement
 Dribbling after urination  Anorectal pain
 Haematuria  Anorectal mass
 Blood in semen  None of the above
Normal Abnormal Remarks (Mandatory if “Abnormal”)
Digital rectal examination (DRE)

 Beneficiary refused  

Page 3 of 4
PEKAB40/HS/HE/2019/01
Section H: Basic Breast Cancer Screening Including Clinical Breast Examination (CBE) [For Females ONLY]

Age at menarche years old Age at menopause years old  Not yet

Parity Number of children Breastfeeding history  Yes  No

Yes No Remarks (Mandatory if “Yes”)
Hormonal history (HRT/OCP/others)  
Genetic testing (BRCA1/BRCA2/others)  
Left Right
 Beneficiary refused CBE Remarks (Mandatory if “Yes”)
Yes No Yes No
Breast pain/tenderness    

Lump in breast    

Nipple discharge    
Skin & nipple changes    
Nipple retraction/inversion    
Axillary nodes swelling    
Biopsy history & HPE    
Previous intervention (surgery/
   
implant/radiotherapy/chemotherapy)
Section I: Laboratory Investigation

Reference number

Date specimen taken D D - M M - Y Y Y Y Time specimen taken H H : M M

Specimen type  Fasting  Non-fasting

Testing laboratory  BP Clinical Lab  Pantai Premier
 Clinipath  Pathlab
 Gribbles Pathology  Quantum Diagnostics
Section J: Initial Screening Outcome
Provisional diagnosis
 No apparent clinical disease
Additional clinical notes (if any)

Appointment for 2nd consultation D D - M M - Y Y Y Y

Full name
Examining
doctor MMC registration number

Section K: Final Review [After Laboratory Results Are Ready]

Laboratory results  Normal  Abnormal
Provisional diagnosis
 No apparent clinical disease
Additional clinical notes (if any)

Full name
Reviewing
doctor MMC registration number

Page 4 of 4
PEKAB40/HS/SC/2019/01

ProtectHealth Corporation Sdn Bhd

Peduli Kesihatan B40 (PeKa B40) Scheme: Health Screening Second Consultation

New IC number - -

Full name

Second Date D D - M M - Y Y Y Y
consultation
Type  Clinic visit  Teleconsultation

Provisional diagnosis (only if update

in diagnosis is required)

Referral to Referral  Referral to Klinik Kesihatan

Klinik proposition
Kesihatan  Treatment at current facility

 Referral not indicated

Only if “Referral to Klinik Kesihatan” is selected

Receiving facility State District

Klinik Kesihatan

Referral to Referral  Referral indicated

MOH hospital proposition
 Referral not indicated

Only if “Referral indicated” is selected.

Receiving facility 1 State

Hospital Department

Receiving facility 2 State

Hospital Department

Receiving facility 3 State

Hospital Department

Doctor Full name

MMC registration number

Page 1 of 1
APPENDIX 10

PHYSICAL ACTIVITY GUIDE

Vigorous Activity Moderate Activity Sedentary

Vigorous – intensity are Moderate-intensity activity Activities that require low

activities that require hard are activities that require physical effort but does not
physical effort cause large moderate physical effort and include time spent for
increases in breathing or cause small increases in sleeping
heart rate breathing or heart rate

Example of activity : Example of activity : Example of activity :

Carrying or lifting Digging or Carrying light

heavy loads construction work
Brisk walking Sitting at work Travelling in car
loads

Cycling at
Aerobic exercises Fast cycling Swimming Reclining Watching TV
normal speeds

Playing Mopping the

Playing football Running / jogging Reading
volleyball floor
APPENDIX 11:
Mental Health Symptoms Screening Questionnaire

• Malay version
• English version
• Chinese version
• Tamil version
PEKAB40/HS/MH/MS/2019/01

ProtectHealth Corporation Sdn Bhd

Saringan Kesihatan Mental

Nombor KP baru - -

Nama lengkap

Tarikh D D - M M - Y Y Y Y

Bahagian A: Soal Selidik Kesihatan Pesakit-9 (PHQ-9)

ARAHAN: Sila tanda “✓” untuk menyatakan jawapan anda
Dalam tempoh 2 minggu yang lepas, berapa kerapkali anda terganggu oleh masalah berikut?
Tidak
Beberapa Lebih dari Hampir
pernah
hari seminggu setiap hari
sama sekali
1. Sedikit minat atau keseronokan dalam melakukan
kerja-kerja
2. Merasa murung, sedih, atau tiada harapan

3. Masalah hendak tidur / semasa tidur, tidur terlalu

banyak
4. Merasa letih atau kurang bertenaga

5. Kurang selera atau terlalu banyak makan

6. Mempunyai perasaan buruk terhadap diri sendiri—

ataupun merasa gagal terhadap diri sendiri ataupun
menghampakan diri atau keluarga
7. Masalah menumpukan perhatian terhadap perkara-
perkara seperti membaca surat khabar atau
menonton televisyen
8. Bergerak atau bercakap dengan terlalu lambat
sehingga disedari oleh orang lain. Ataupun
bertentangan—terlalu resah atau gelisah sehingga
anda bergerak lebih dari biasa
9. Berfikiran bahawa lebih elok jika anda telah mati atau
ingin mencederakan diri anda dalam sesuatu cara

Sambung muka surat belakang ➔

Halaman 1 dari 2
PEKAB40/HS/MH/MS/2019/01

Bahagian B: Soal Selidik Gangguan Kebimbangan Umum-7 (GAD-7)

Dalam tempoh 2 minggu yang lepas, berapa kerapkali anda terganggu oleh masalah berikut?
Tidak
Beberapa Lebih dari Hampir
pernah
hari seminggu setiap hari
sama sekali
1. Berasa resah, gelisah atau tegang

2. Tidak dapat menghentikan atau mengawal

kebimbangan
3. Terlalu bimbang mengenai pelbagai perkara yang
berlainan
4. Mempunyai masalah untuk tenang

5. Terlalu resah sehingga susah untuk berdiam diri

6. Mudah menjadi rimas dan menjengkelkan

7. Berasa takut bahawa sesuatu yang buruk akan terjadi

Halaman 2 dari 2
PEKAB40/HS/MH/EN/2019/01

ProtectHealth Corporation Sdn Bhd

Mental Health Screening

New IC number - -

Full name

Date D D - M M - Y Y Y Y

INSTRUCTION: Use “✓” to indicate your answer.

Section A: Patient Health Questionnaire-9 (PHQ-9)
Over the last 2 weeks, how often have you been bothered by any of the following problems?
More Nearly
Several
Not at all than half every
days
the days day
1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself—or that you are a failure or have
let yourself or your family down
7. Trouble concentrating on things, such as reading the
newspaper or watching television
8. Moving or speaking so slowly that other people could have
noticed. Or the opposite—being so fidgety or restless that
you have been moving around a lot more than usual
9. Thoughts that you would be better off dead or of hurting
yourself in some way
Section B: Generalised Anxiety Disorder-7 Questionnaire (GAD-7)
Over the last 2 weeks, how often have you been bothered by the following problems?
More Nearly
Several
Not at all than half every
days
the days day
1. Feeling nervous, anxious or on edge
2. Not being able to stop or control worrying
3. Worrying too much about different things
4. Trouble relaxing
5. Being so restless that it is hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid as if something awful might happen

Page 1 of 1
PEKAB40/HS/MH/ZH-HANT/2019/01

ProtectHealth Corporation Sdn Bhd

心理健康篩查

新身份證號碼 - -

英文姓名
日期年月日
提示：請勾選“✓”您的答案。
（一）病人健康狀況問卷抑鬱量表 (PHQ-9）
在過去兩個星期，有多少時候您受到以下任何問題所困擾？
完全一半以上幾乎
幾天
沒有的天數每天
1. 做事時提不起勁或沒有樂趣
2. 感到心情低落、沮喪或絕望
3. 入睡困難、睡不安穩或睡眠過多
4. 感覺疲倦或沒有活力
5. 食慾不振或吃太多
6. 覺得自己很糟—或覺得自己很失敗，或讓自己或家人
失望
7. 對事物專注有困難，例如閱讀報紙或看電視時
8. 動作或說話速度緩慢到別人已經察覺，或正好相反—
煩躁或坐立不安、動來動去的情況更勝於平常
9. 有不如死掉或用某種方式傷害自己的念頭
（二）廣泛性焦慮量表（GAD-7）
在過去兩個星期，有多少時候您受到以下任何問題所困擾？
完全一半以上幾乎
幾天
沒有的天數每天
1. 感到緊張、不安或煩躁
2. 無法停止或控制憂慮
3. 對各種事情過度擔憂
4. 身心難以放鬆
5. 焦躁不安，以至於很難安靜地坐下來
6. 容易心煩或生氣
7. 感到害怕，好像有可怕的事情要發生一樣

第1頁，共1頁
PEKAB40/HS/MH/TA/2019/01

ProtectHealth Corporation Sdn Bhd

மன நலப் பரிச ோதனன

புதிய அடையாள அட்டை எண் - -

பபயர்

தததி D D - M M - Y Y Y Y

குறிப்பு : ௨ங்கள் பதினல குறிக்க "✓" ச ய்யவும்

சநோயோளியின் சுகோதோரம் சதோடர்போன சகள்வித்தோள் (PHQ-9)

கடந்த 2 வோரங்களில், பின்வரும் பிரச்சடைகளால் நீங்கள் எத்தடை நாட்களுக்கு

பாதிப்படைந்தீர்கள்?

ஒரு ஒரு கிட்ைத்தட்ை

இல்டை சிை வாரத்திற்கும் ஒவ்பவாரு
நாட்கள் தேைாக நாளும்

1. தவடை பசய்வதில் சிரிதளவு ஆர்வம் அல்ைது

ேகிழ்ச்சி

2. ேைச்தசார்வு, தசாகம், அல்ைது

நம்பிக்டகயில்ைா உணர்வு

3. தூங்குவதற்கு / தூங்குவதில் சிக்கல், அல்ைது

அதிக தூக்கம்

4. தசார்வாக அல்ைது ஆற்றல் குடறவாக

இருப்படத உணர்தல்

5. பசியின்டே அல்ைது அதிகோக சாப்பிடுதல்

6. உங்கடளப் பற்றி நீங்கதள தவறாக எண்ணுதல்

– அல்ைது தன்நம்பிக்டகயின்டே ேற்றும்
குடும்ப உருப்பிைர்களின் நம்பிக்டகடய
இழந்துவிட்ைதாக எண்ணுதல்

7. கவைம் பசலுத்துவதில் சிரேம் –

உதாரணத்திற்கு பசய்தித்தாடளப் படிப்பது
அல்ைது பதாடைக்காட்சிடயப் பார்ப்பது

8. நீங்கள் ேிகவும் பேதுவாக தபசுவடத ேற்றும்

அடசவடத ேற்றவர்கள்
உணர்ந்திருக்கிறார்களா? - அல்ைது
வழக்கத்திற்கு ோறாக அடேதியின்றி,
பதட்றோக அங்கும் இங்கும்
நைந்துக்பகாண்டிருந்தீர்களா?

9. நீங்கள் உயிருைன் இருப்படதவிை இறப்பதத

தேல் என்ற எண்ணம் அல்ைது உங்கடள
நீங்கதள காயப்படுத்திக்பகாள்ள எண்ணுதல்

பக்கம் 1/2
PEKAB40/HS/MH/TA/2019/01

பதட்டம் மற்றும் கவனள (Anxiety Disorder) சதோடர்போன சகள்வித்தோள் (GAD-7)

கடந்த 2 வோரங்களில், பின்வரும் பிரச்சடைகளால் நீங்கள் எத்தடை நாட்களுக்கு
பாதிப்படைந்தீர்கள்?

ஒரு ஒரு கிட்ைத்தட்ை

இல்டை சிை வாரத்திற்கும் ஒவ்பவாரு
நாட்கள் தேைாக நாளும்

1. அடேதியின்டே, பதட்றம் அல்ைது ேை

அழுத்தம் அடைதல்

2. கவடைப்படுவடதத் தடுக்க அல்ைது

கட்டுப்படுத்த இயைாடே

3. பல்தவறு விஷயங்கடளப் பற்றி ேிக

அதிகோக கவடைப்படுதல்

4. ஓய்வு ேற்றும் ேை அடேதி நிடை அடைவதில்

சிரேம்

5. பதட்றம் காரணத்திைால் அடேதியின்றி

அங்கும் இங்கும் அடைதோதுதல்

6. எளிதில் தகாபேடைதல் ேற்றும் எரிச்சைடைதல்

7. தோசோை நிகழ்வு நைக்கப்தபாகிறது என்ற

அச்சம்/ பயம்

பக்கம் 2/2
APPENDIX 12:
Laboratory Investigation Parameters

Full Blood Count

Hemoglobin
RBC
MCV
HCT
MCH
MCHC
RDW-CV
WBC
Neutrophils
Lympocytes
Monocytes
Eosinophils
Basophils
Platelets

Renal Profile
Sodium
Potassium
Urea
Creatinine
Estimated Glomerular Filtration Rate (E-Gfr)

HbA1c

Random Lipid Profile

Total Cholesterol
Triglyceride
HDL Cholesterol
LDL Cholesterol
Total Cholesterol/HDL-Cholesterol

Urine Biochemistry
Appearance
Colour
Specific gravity
pH
Leucocytes
Nitrite
Protein
Glucose
Ketones
Urobilinogen
Bilirubin
Blood
APPENDIX 13
ProtectHealth Corporation Sdn Bhd
(1212734 -T}
F01 & F02, 1st Floor, Block 2300
Century Square, Jalan Usahawan
63000 CyberJaya, Selangor
T +603 8687 2500
F +603 8687 2599
Peduli Kesihatan untuk Kumpulan B40 E [email protected]
Referral Letter www.protecthealth.com.my

Referral to:
Date/time:

Dear Colleague,
Thank you for seeing this patient.

Referral Indications

Please kindly review this patient and do the needful.

The PeKa B40 Health Screening Summary is also attached for your further reference.
Thank you for your anticipated assistance.

_____________________________________
Name :
MMC Number :
Doctor’s Stamp :
APPENDIX 14

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Manual For MOH Hospital

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Manual For MOH Hospital

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REF. NO.

GENERAL INFORMATION ................................................................................................................ 3

1.2 BACKGROUND .................................................................................................................... 3

1.3 THE BENEFITS MANAGEMENT SYSTEM ..................................................................... 3

1.4 PERSON IN CHARGE (PIC) .............................................................................................. 4

1.5 COMMUNICATION .............................................................................................................. 4

HEALTH AID BENEFIT ...................................................................................................................... 5

2.2 TERMS AND CONDITIONS FOR APPLICATION.......................................................... 5

2.3 TYPES OF HEALTH AID CATEGORIES ......................................................................... 6

2.4 DETAILED LIST OF HA BY CATEGORIES - SURGICAL CATEGORIES ................ 6

2.5 DETAILED LIST OF HA BY CATEGORIES - NON-SURGICAL CATEGORIES ...... 9

2.6 APPLICATION PROCESS ............................................................................................... 10

2.7 REJECTION OF APPLICATION ..................................................................................... 14

2.8 CO-PAYMENT PROCESS ................................................................................................ 14

2.9 REVIEW OF APPLICATION............................................................................................. 15

2.10 APPROVAL OF APPLICATION ...................................................................................... 15

2.11 OVERALL TAT FOR HA APPROVAL ........................................................................... 16

2.12 DELIVERY TIME AND VERIFICATION ......................................................................... 17

2.13 PAYMENT OF HEALTH AID ............................................................................................ 17

2.14 HA WORKFLOW: PRE-HA APPROVAL FLOW .......................................................... 19

2.15 HA WORKFLOW: POST- HA APPROVAL FLOW ...................................................... 20

COMPLETING CANCER TREATMENT INCENTIVE (CCTI)..................................................... 21

3.2 ELIGIBILITY ........................................................................................................................ 21

3.3 AUTHORISED USERS FOR CCTI .................................................................................. 22

3.4 CCTI APPLICATION & FIRST PAYMENT OF THE INCENTIVE .............................. 23

3.5 TRANSPORT INCENTIVE AND FOLLOW UP MODULE ........................................... 24

3.6 SECOND PAYMENT OF THE INCENTIVE ................................................................... 24

3.7 CCTI WORKFLOW ............................................................................................................ 25

4.2 APPLICATION OF TRANSPORT INCENTIVE ............................................................. 28

4.4 TRANSPORT INCENTIVE WORKFLOW DIAGRAM .................................................. 30

HEALTH ASSESSMENT .................................................................................................................. 31

5.2 HEALTH ASSESSMENT COMPONENTS ..................................................................... 31

5.3 HEALTH ASSESSMENT PROCESS .............................................................................. 31

5.4 HOSPITAL RECORD......................................................................................................... 33

5.5 BENEFICIARY CONSENT ............................................................................................... 33

5.6 UPDATING BENEFICIARY’S INFORMATION ............................................................. 33

5.7 HEALTH ASSESSMENT FORMAT ................................................................................ 34

5.8 PROVISIONAL DIAGNOSIS ............................................................................................ 35

5.9 LABORATORY INVESTIGATIONS ................................................................................ 35

5.10 CONSULTATION AND REFERRAL ............................................................................... 35

5.11 ENTERING HEALTH ASSESSMENT DETAILS INTO BMS ...................................... 35

5.12 HEALTH ASSESSMENT WORKFLOW ......................................................................... 36

UPDATING REFERRAL CASES .................................................................................................... 37

6.2 UPDATING REFERRAL WORKFLOW .......................................................................... 37

PeKa B40 Manual for MOH Hospital

1.1 PURPOSE AND AUDIENCE

• Benefit 1: Health Screening

1.3 THE BENEFITS MANAGEMENT SYSTEM

PeKa B40 Manual for MOH Hospital

BMS Website: https://bms.pekab40.com.my/site/login

1.4 PERSON IN CHARGE (PIC)

1.4.1 PIC Appointment

1.4.2 Roles and Responsibilities of PIC

Any enquiries, complaint or any form of feedback can be directed to ProtectHealth as

Toll-Free number 1-800-180-755

PeKa B40 Manual for MOH Hospital

2.1 ABOUT THE BENEFIT

2.1.2 Definition of Health Aid

2.1.3 PeKa B40 HA Benefit

It has a lifetime limit of RM 20,000 per beneficiary (head of household and

2.2 TERMS AND CONDITIONS FOR APPLICATION

2.2.1 Prerequisite for HA

a) Open to all PeKa B40 beneficiaries

a) Not a PeKa B40 beneficiaries

PeKa B40 Manual for MOH Hospital

2.3 TYPES OF HEALTH AID CATEGORIES

a) Surgical HA are HAs requiring surgical procedures

Surgical Items Categories Non-Surgical Items Categories

2.4 DETAILED LIST OF HA BY CATEGORIES - SURGICAL CATEGORIES

2.4.1 Cardiac Stent

PeKa B40 Manual for MOH Hospital

a) Primary total hip arthroplasty

2.4.4 Spinal Surgery Prosthesis and Implants

PeKa B40 Manual for MOH Hospital

2.4.6 Intraocular Lens

PeKa B40 Manual for MOH Hospital