The National Bowel Screening Programme has two objectives; reduce mortality rates from bowel cancer and to identify and remove pre-cancerous advanced adenoma from the bowel before they become cancerous.
This service provides funding for the primary care management of positive FIT (faecal immunochemical test) results including consulting with the patient and facilitating the referral of these individuals through to Te Whatu Ora Waikato for colonoscopy.
It is also expected that primary care providers will further support the programme by raising bowel screening awareness with eligible people, encouraging participation particularly for Māori and Pacific Island people, and continue to work to identify and manage bowel cancer risk in the non-screening age population in line with clinical guidelines.
Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agree to the business rules set out in this service sheet.
This is not a clinical guideline.
Any Pinnacle practice in the Waikato region can offer and claim for this service.
The service offers funding for the management of positive FIT results. For the purpose of this service, 'management' must include:
Any participant in the National Bowel Screening Programme, resident in the Te Whatu Ora Waikato area and enrolled with a Pinnacle practice who has had a positive FIT test result.
Any participants in the National Bowel Screening Programme who have had a negative FIT test result
Patients outside the National Bowel Screening Programme (not aged between 60-74, inclusive), these patients should be managed in line with clinical guidelines and are not included in this service.
The episode of care is complete when the GP submits the BPAC eReferral to Te Whatu Ora Waikato. This act also triggers the claiming mechanism.
Funding is for $72.45 (GST inclusive) per episode of care which includes:
Claiming process
Payments will be made monthly based on the number of eReferrals submitted by a practice and will be processed on your practice’s behalf by Pinnacle, based on a monthly eReferrals report from Te Whatu Ora.
The payment from Pinnacle to your practice will be accompanied by a report containing the NHI details of the individuals referred in that month, for which the payment is for.
You may choose to create a service code and account within your PMS to keep track of the outstanding claims and reconcile against.
No.
This service is funded by Te Whatu Ora.
Selena Batt, Regional Support Manager (Screening Services)
selena.batt@pinnacle.health.nz
021 411 245
National Bowel Screening Programme resources including the clinical Zoom recording and quick reference guide for primary healthcare teams.
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