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Information From HealthPac
						
				
				
						
								Maternity Summary 
								1st / 2nd Trimester 
								Full module 
						
						
						
				
				Payable when first registered before the start of the 18th week 
				Module end date (last date of service) MUST be on or BEFORE the end of the 28th 
				week. 
				If a change of registration to another LMC has occurred after the start of the 18th 
				week, you can still claim the full module but the module end date MUST be one day 
				prior to the start date of next registration. You will need to contact HealthPAC to 
				obtain date of next registration
				
						
								
										
												     ERROR                         POSSIBLE PROBLEM          
										
								
						
						
								
										      Date of module end must             Has the correct module end 
								
						
						
								
										      be between the start of the          date been supplied 
								
						
						
								
										      4th and the end of the 6th  
								
						
						
								
										      week following birth 
								
						
						
								________________________________________________________  
						
								      Registration ended before           Has there been a change         the end of the 3rd week  
						             of registration, HealthPAC       after delivery                                will need to confirm this 
						
								________________________________________________________  
						
						
								    
						
						
								   Maternity Provider/Practitioner      Does a valid registration        is not the registered LMC at          exist for claiming LMC?       the date of service          
						
								              Has there been a change                                                               of registration, HealthPAC 
						
						
								                                                             will need to confirm                                                                this    
						
						
								________________________________________________________     
						
						
								
								
						
				
		
		
				
						
						
				
		
		
				
						
								
										First partial
										 
								
						
				
		
		
				• 
				Payable when a change of registration to another LMC occurred before the 
		
		start of the 4th week following birth 
		
				• 
				Module end date (last date of service) MUST 
				be one day prior to start date of 
		
		next registration
		
				
						
								      ERROR                              POSSIBLE PROBLEM   
						
				
				
						        Date of module end must be          Has the correct module end          between Date of Birth and              date been supplied?         the end of the 3rd week after          birth 
				
				
						________________________________________________________       Maternity Provider/Practitioner       Does a valid registration 
				
				
						      is not the registered LMC at             exist for claiming LMC? 
				
				
						      at the date of service                         
				
						                                                                Has there been a change  
				
				
						                                                                of registration HealthPAC                                                                 will need to confirm this ________________________________________________________
				
		
		
				
						
								
										Last partial 
								
						
				
				
						• 
						Payable when first registered after the start of the 18th week. 
				
				
						• 
						The module end date (last date of service) MUST be on or BEFORE the end of 
				
				the 28th week.
		
		
				
						
								       ERROR                              POSSIBLE PROBLEM    
						
				
				
						        No registration between the           Is the registration start date         start of the 18th week and              BEFORE the start of the 18th         the end of the 26th week                week
						 
				
				
						________________________________________________________  
				
						      Maternity Provider/Practitioner         Does a valid registration  
				
				
						       is not the registered LMC at the        exist for claiming LMC? 
				
				
						      date of service                                    
				
				
						                                                                  Has there been a change of                                                                   registration, HealthPAC will                                                                   need to confirm this 
				
				
						________________________________________________________
				
		
		
				
						         
				
		
		
				3rd Trimester 
				Full Module 
		
		
				• 
				Payable when first registered before the start of the 35th week and completed full module 
		
		
				• 
				Module end date (last date of service) MUST be the SAME as baby’s date of birth 
		
		
				• 
				If a change of registration to another LMC has occurred after the start of the 35th week, you can 
		
		still claim the full module but the module end date MUST be one day prior to the start date of next 
		
				registration
				.
		
		
				
						
								          ERROR                         POSSIBLE  PROBLEM  
				
				   Registration ended before the               Has there been a change of    start of the 35th week                             registration, HealthPAC will 
				                                                                  need to confirm this 
				_______________________________________________________         Maternity Provider/Practitioner          Does a valid registration exist 
				    is not the registered LMC at the         for claiming LMC? 
				    date of service                                                                                                     Has there been a change of                                                                  registration, HealthPAC will                                                                 need to confim this _______________________________________________________  No accepted registration before           Does a valid registration exist  the start of the 35th week                     for claiming LMC?                                                              May be eligible for last partial ________________________________________________________ First partial • Payable when first registered and has been a change of registration to another LMC before the start of the 35th week. • NOT payable of the change of registration has occurred before the start of the 31st week. • Module end date MUST be the last date of service or one day prior to next registration, which ever is applicable 
		
				
						Last partial 
				
		
		• Payable if first registered after the start of the 35th week • Module end date (date of service) MUST be the same baby’s date of birth 
		
				
						Services Following Birth Full module 
				
				
				
		
		• Payable when registered and completed the full module • Module end date (last date of service) MUST be on or BEFORE the end of 6th eek following birth • Payable when a change of registration occurred after the start of the 4th week following birth, but the module end date (last date of service) MUST be one day prior to next registration date 
		
				
						First partial • Payable when a change of registration to another LMC occurred before the start of the 4th week following birth • Module end date (last date of service) MUST be one day prior to start date of next registration
		
		
				
						
								      ERROR                        POSSIBLE PROBLEM         
						
				
				Registration ended before the     Has there been a change of registration start of the 35th week                   HealtPAC will need to confirm this 
				_________________________________________________________ Maternity Provider/Practitioner     Does a valid registration exist for is not the registered LMC at the    claiming LMC? 
				at the date of service                   Has there been a change of registration 
				                                                    HealthPAC will need to confirm this _________________________________________________________ 
				No accepted registration before    Does a valid registration exist for the start of the 35th week              claiming LMC?                                                       May be eligible for last partial _________________________________________________________ 
		
		
				
						
								Last Partial 
						
				
				
						• 
						Payable when first registered after the start of the 4th week following birth 
				
				
						• 
						Module end date (last date of service) MUST be on or BEFORE the end of 6th 
				
				week following birth
		
		
				
						
								Non LMC Services
						
				
				
						
								
										ERROR                             POSSIBLE PROBLEM       
								
						
				
				
						
								Date of module end must be       Has the correct module end date been between the 31st week and the   supplied on claim end of the 24th week          _________________________________________________________
				
				
						Maternity Provider/Practitioner is   Does a valid registration exist for 
						not the registered LMC at the        claiming LMC? date of service                             Has there been a change of registration 
						                                                    HealthPAC will need to confirm this _________________________________________________________
				
				
						
								 
						
				
				
						
								
										
												First trimester services
												 
										
								
						
				
		
		• 
		
				Only one fee payable per woman per pregnancy 
				• 
		
		
				Must be enrolled to your practice through PHO 
		
		
				• 
				
						Must confirm the pregnancy 
						• 
						Date of service (module end date) must NOT be past the end of the 14th week 
						and MUST be claimed after the module has been completed
				
		
		
				
						
								ERROR                              POSSIBLE PROBLEM         
						
				
		
		
				
						No registration after the end date  Does a valid registration exist for 
						of the 34th week                             claiming LMC? 
				
				                                                      Is the regisitration BEFORE the                                                          start of the 35th week? _________________________________________
		
				
						
								Maternity Provider/Practitioner  
						
				
				
						
								  Does a valid registration exist for the registered LMC at the date      claiming LMC? of service                                      Has there been a change of  
						
				
				
						
								                                                       registration, HealthPAC will need to 
						
				
				
						
								                                                       confirm this
								 
						
				
				
						
								_________________________________________________________ 
						
				
				
						
								                                                                                                         
						
				
		
		
				
						
								Urgent Pregnancy Care 
						
				
				This fee to be claimed if woman is NOT enrolled to your practice through PHO • 
				One fee payable per date of service
		
		
				
						
								
										ERROR                            POSSIBLE PROBLEM          
								    
				
				
						
								Date of module end must be          Has the correct module end date 
						
				
				
						between the start of the 4th and   been supplied 
				
				
						the end of the 6th week following 
				
				
						
								birth  ________________________________________________ 
						
								
										Re
								
						
				
				gistration ended before the        Has there been a change of  
				
						
								endof the 3rd week after             
						registration, HealthPAC will need to 
				
				
						
								delivery                                   confirm this.
				
				 ___________________________________________ Maternity Provider/Practitioner       Does a valid registration exist for is not the registered LMC at the      claiming LMC? date of service                                Has there been a change of                                                        registration, HealthPAC will need to                                                        confirm this  __________________________________________________________
		
				This fee to be used when you are providing a service for “following termination or miscarriage”, original EDD to be used within the claim • Fee can be claimed at ANY time throughout the pregnancy as long as you are NOT the LMC
		
		
				
						
								ERROR                                    POSSIBLE PROBLEM   
						
						
								Date of module end must be        Has the correct module end date between Date of Birth & the          been supplied end of the 3rd                       _______________________________________________________ Maternity Provider/Practitioner   Does a valid registration exist for 
						
				
				
						
								is not the registered LMC at the  claiming LMC? date of service                              Has there been a change of                                                        registration, HealthPAC will need 
						                                                       to confitm this        
				
						
								________________________________________________________
						
				
		
		
				
						
								HealthPac Business Advisor Mark Huston