ProtectHealth Corporation Sdn. Bhd. aowoum izunen Estoblihed under the F018 02, Levelt Block 2000 Mit f Heath aay ‘Century Square, an Usshanan $3000 Cybenye Selangor al san PROTECTHEALTH ‘Gwmprotecthestheommy [2info@pretctheathconmy (#608 8687 2500 Ruj. Kami: PHC/SP/PB40/L/0421/17 Tarikh: 19 April 2021 Person-In-Charge PeKa B40 Partner Klinik Kesihatan Dear Dr, DIAGNOSIS GUIDE FOR PATIENT(S) SCREENED UNDER PEKA B40 Thank you for actively participating in Skim Peduli Kesihatan untuk Kumpulan B40 (PeKa B40). We appreciate your contribution in improving the health status of Malaysians, particularly the B40 population. 2. As part of our continuous effort to improve PeKa B40, ProtectHealth Corporation Sdn Bhd (ProtectHealth) checks and audits diagnosis made for the beneficiaries screened under this program 3. The checking of the diagnosis (at 1" and 2" visits) is incorporated into our claim processing. Hence, we would like to provide a guide for you to understand what ProtectHealth emphasises in the diagnosis of PeKa B40 patients. We may seek clarification from you if no appropriate diagnosis is made, or no proper explanations are provided, according to ProtectHealth criteria. Failure to cooperate with our requirement may result in delay of payment. 4. Table 1 below are the criteria used by ProtectHealth to identify cases that need relevant diagnosis: Your Health, Our MissionTable NOTE: * Diagnosis is NOT limited to these criteria. eKa B40 Guide for NEW DIAGNOS| * Provider has to evaluate patient overall clinical condition and diagnose accordingly. * For Diabetes Mellitus, Hypertension & Dyslipidaemia, please refer to Clinical Practice Guidelines (MOH). * Provider must make appropriate diagnosis if a patient's condition fulfil any of the PeKa B40 criteria in this table at the BMS Diagnosis Section. « If diagnosis is deemed not required even when the patient's condition fulfil the criteria, provider has to provide additional information in BMS Additional Clinical Notes Section. * For diseases already listed at the diagnosis section, please fully utilize the check boxes. Any extra information please add in the additional clinical notes section. No | New Diagnosis Criteria 1 & NO known Diabetes Diabetes Mellitus HbAtc > 6.3% , Mellitus 2 beolutal SBP > 140 or no not Hien tension nown Hypertension = DBP > 90 mmHg " 3 & NO known Dyslipidemia TC > 5.2 mmol/L : Dyslipidaemia 4 ‘& NO known Mental Anxiety PHQ2> 10 Illness. 5 & NO known Mental Depression GAD 2 10 Miness 6 oe “| eGFR < 45 mimin//1.73 & NO known Chronic enal Impairment | = m Kidney Disease | 7 ‘Abnormal findings during | & NO known Breast Breast abnormalities clinical breast “at Cancer examination 8 ‘Abnormal findings during Prostate & NO known colorectal or : Digital Rectal abnormalities prostate disease Examination Your Health, Our MissionReferences: * Clinical Practice Guidelines - Management of Type 2 Diabetes Mellitus (6 edition); 2020 * Clinical Practice Guidelines - Management of Hypertension (5 edition), 2018. * Clinical Practice Guidelines - Management of Dyslipidaemia (5 edition), 2017. + Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med, 16(9), 606-613. doi:10,1046/.1525-1497.2001.016009606. © Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Archives of Intemal Medicine, 166(10), 1092-1097. doi:10.1001/archinte.166.10.1092 Your attention and cooperation regarding this matter is highly appreciated to ensure that PeKa B40 patients get the necessary diagnosis and continuity of care. We thank you in advance and look forward for your feedback, “Lebih PeKa, Lebih Cakna” Yours sincerely, ok ANAS ALAM FAIZLI > Chief Executive Officer