FAQs
Which patients are eligible to receive Primary Options services?
Patients who would normally require an acute hospital referral and currently reside within the Counties Manukau, Auckland or Waitemata DHB boundaries
Patients who have temporary residence in Counties Manukau, Auckland or Waitemata Districts e.g. NZ residents on holiday or whom have temporary residence with family members/whanau in these regions
Which patients are not eligible to receive Primary Options services?
The Doctor who initially refers the patient carries clinical responsibility, unless that Doctor has specifically handed over care to another Doctor.
What if the patient is registered with another GP?
When a Doctor who is not the patient’s GP, refers a patient to the service, (the initiating doctor), he/she agrees to advise and handover care to the patient’s GP at the earliest practical opportunity e.g. the next working day.
The initiating doctor carries clinical responsibility for managing the patient’s acute illness until the responsibility has been accepted by the patient’s GP.
Does the patient need to be enrolled with us?
No, patients do not need to be enrolled with you or any other practice to receive treatment under this service.
How can services be accessed for patients?
Phone the coordinator on (09) 535 7218 and services will be arranged on behalf of your patient
What if the services required cost more than budgeted amount?
If the cost of an episode of care is likely to exceed the budget, please phone the Primary Options coordinator for approval to extend this on (09) 535 7218. If an Ultrasound has been approved, the budgeted cost is automatically adjusted to suit.
Refer to Claiming Guidelines in this manual for more information.
Does the patient have to pay for any services?
No. The initial GP consultation incurs the usual charge and thereafter all services are provided at no cost to the patient.
What is the claiming procedure for Practice based services?
Notification: Complete the patient details on the referral form; attach a case reference label and fax the form (09) 535 7154
Completion of care: Complete the referral form and fax or post to us once the episode of care has been completed, no later than 30 days following initiation, along with Clinical Notes for each day of treatment.
Electronic Claiming: Referrals can be processed electronically, please contact Service Manager on (09) 535 7218 for more information.
Will Primary Options pay for after hours follow up or home visits if needed?
Yes. Either the GP, the deputised after hour’s services, Home Care Medical, or a local A&M, can provide after hours care to your patient.
What about after hours?
This is a 24 hour service. The office hours are 0900-1700hrs Monday to Friday, outside these hours the calls are answered by an after hours call service.
What if my patient eventually needs to be admitted?
Refer to hospital services in the usual way. It is essential that patients be admitted when necessary, risks should never be taken to avoid admission.
Primary Options will pay for services provided up to referral to hospital.
Can services be accessed for the same patient, for more than one episode?
Yes, funding is allocated per patient, per episode as clinically required.
Who can help with medical management advice?
The Primary Options Clinical Director or the hospital Medical Registar.
Who can assist with administration advice?
Call the Primary Options office between 0900-1700hrs Monday-Friday on (09) 535 7218 for all admin queries
How much should I charge?
Charge your normal non-funded fee to POAC for GP consultations, no GMS should be claimed for POAC visits. We have set fees for some services which are detailed in the claiming guide in the POAC information manual or on our website.
When should an episode of care end?
POAC funds for the acute episode only. The patient should be discharged when they are no longer acutely unwell and needing the increased level of care that POAC funds. This is usually within 3-5 days but may be longer under some circumstances. If an extension is required, please phone the POAC office for approval.
How often should the patient be seen while under POAC?
Generally it would be expected that the patient is reviewed every day while they are acutely unwell and under POAC.
Does POAC fund ongoing dressing changes?
No, once the patient is well enough to be discharged from POAC (usually within 24 hours of last IV Antibiotic dose) then any ongoing dressings should be referred to District Nursing, or the patient would pay.
What happens if the patient needs to be admitted to hospital?
If a patient is admitted then this ends the POAC episode of care. Complete the POAC claim as normal and indicate that the patient was admitted under the outcome.
Any follow up post discharge should be consider standard care and is not funded by POAC.
How can I get additional forms and case reference numbers?
Phone (09) 535 7218 or email poac@easthealth.co.nz
How does the Electronic Claiming work?
The POAC Electronic Claim Management system is integrated with your PMS and enables claims to be lodged electronically directly to us from your PMS
How do I get set up for Electronic Claiming?
Contact the Service Manager on (09) 535 7218 or email poac@easthealth.co.nz
There is no charge to have this set up.
Patients who would normally require an acute hospital referral and currently reside within the Counties Manukau, Auckland or Waitemata DHB boundaries
Patients who have temporary residence in Counties Manukau, Auckland or Waitemata Districts e.g. NZ residents on holiday or whom have temporary residence with family members/whanau in these regions
Which patients are not eligible to receive Primary Options services?
- Patients who have suffered a stroke
- Frail and elderly patients who are at risk
- Patients with chest pain of cardiac origin (refer to Clinical Guideline and Policy)
- Non NZ Citizens - as outlined in this manual
- Patients whose treatment may be covered by another funding stream such as ACC or Maternity (with exception of Hyperemesis treatment)
- If in any doubt over safety of treatment, always refer to the Clinical Director or Hospital Medical Registrar for advice
The Doctor who initially refers the patient carries clinical responsibility, unless that Doctor has specifically handed over care to another Doctor.
What if the patient is registered with another GP?
When a Doctor who is not the patient’s GP, refers a patient to the service, (the initiating doctor), he/she agrees to advise and handover care to the patient’s GP at the earliest practical opportunity e.g. the next working day.
The initiating doctor carries clinical responsibility for managing the patient’s acute illness until the responsibility has been accepted by the patient’s GP.
Does the patient need to be enrolled with us?
No, patients do not need to be enrolled with you or any other practice to receive treatment under this service.
How can services be accessed for patients?
Phone the coordinator on (09) 535 7218 and services will be arranged on behalf of your patient
What if the services required cost more than budgeted amount?
If the cost of an episode of care is likely to exceed the budget, please phone the Primary Options coordinator for approval to extend this on (09) 535 7218. If an Ultrasound has been approved, the budgeted cost is automatically adjusted to suit.
Refer to Claiming Guidelines in this manual for more information.
Does the patient have to pay for any services?
No. The initial GP consultation incurs the usual charge and thereafter all services are provided at no cost to the patient.
What is the claiming procedure for Practice based services?
Notification: Complete the patient details on the referral form; attach a case reference label and fax the form (09) 535 7154
Completion of care: Complete the referral form and fax or post to us once the episode of care has been completed, no later than 30 days following initiation, along with Clinical Notes for each day of treatment.
Electronic Claiming: Referrals can be processed electronically, please contact Service Manager on (09) 535 7218 for more information.
Will Primary Options pay for after hours follow up or home visits if needed?
Yes. Either the GP, the deputised after hour’s services, Home Care Medical, or a local A&M, can provide after hours care to your patient.
What about after hours?
This is a 24 hour service. The office hours are 0900-1700hrs Monday to Friday, outside these hours the calls are answered by an after hours call service.
What if my patient eventually needs to be admitted?
Refer to hospital services in the usual way. It is essential that patients be admitted when necessary, risks should never be taken to avoid admission.
Primary Options will pay for services provided up to referral to hospital.
Can services be accessed for the same patient, for more than one episode?
Yes, funding is allocated per patient, per episode as clinically required.
Who can help with medical management advice?
The Primary Options Clinical Director or the hospital Medical Registar.
Who can assist with administration advice?
Call the Primary Options office between 0900-1700hrs Monday-Friday on (09) 535 7218 for all admin queries
How much should I charge?
Charge your normal non-funded fee to POAC for GP consultations, no GMS should be claimed for POAC visits. We have set fees for some services which are detailed in the claiming guide in the POAC information manual or on our website.
When should an episode of care end?
POAC funds for the acute episode only. The patient should be discharged when they are no longer acutely unwell and needing the increased level of care that POAC funds. This is usually within 3-5 days but may be longer under some circumstances. If an extension is required, please phone the POAC office for approval.
How often should the patient be seen while under POAC?
Generally it would be expected that the patient is reviewed every day while they are acutely unwell and under POAC.
Does POAC fund ongoing dressing changes?
No, once the patient is well enough to be discharged from POAC (usually within 24 hours of last IV Antibiotic dose) then any ongoing dressings should be referred to District Nursing, or the patient would pay.
What happens if the patient needs to be admitted to hospital?
If a patient is admitted then this ends the POAC episode of care. Complete the POAC claim as normal and indicate that the patient was admitted under the outcome.
Any follow up post discharge should be consider standard care and is not funded by POAC.
How can I get additional forms and case reference numbers?
Phone (09) 535 7218 or email poac@easthealth.co.nz
How does the Electronic Claiming work?
The POAC Electronic Claim Management system is integrated with your PMS and enables claims to be lodged electronically directly to us from your PMS
How do I get set up for Electronic Claiming?
Contact the Service Manager on (09) 535 7218 or email poac@easthealth.co.nz
There is no charge to have this set up.