Treatment of patients who are acutely unwell and for whom 4 nights of respite care would be sufficient to avoid a hospital admission.
This service is part of the Primary Options for Acute Care (POAC) programme.
Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agreed to the business rules set out here.
This is NOT a clinical guideline.
All practices in Tairāwhiti region can claim for this service.
NB: Respite care under POAC is not to be utilised to support discharge from hospital or a failed discharge from hospital.
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
Once the episode of care is completed and the patient is no longer acutely unwell, they exit the POAC programme.
Once the patient exits the POAC programme, the case requires a clinical outcome to be lodged. No payment can be made for any claims unless the outcome is completed.
Where treatment in the community is no longer clinically appropriate, the patient may be admitted to hospital during a POAC plan of care. Please indicate this in the clinical outcome.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient. If the claim cannot be funded by POAC, the patient may be liable to the practice for the fees incurred.
Respite care is for those patients who require rest home level care rather than hospital level care.
The request for respite care is to be made via the Primary Options team who will then authorise funding for the placement of the patient.
Once funding is approved the practice can then liaise directly with the whanau and respite care providers to determine the most suitable available placement.
Please note:
Contracted respite providers are funded directly through Primary Options. The facility can contact the Primary Options team to confirm funding should they choose, however providing the facility with the patients authorised Primary Options number is sufficient.
Please make your claim via Primary Options, select Respite Care and then attach the appropriate invoice(s).
Prices listed below are GST inclusive.
GP/NP/CP extended consultation: $79 or
Rural GP/NP/CP extended consultation: $89 or
This funding is available to those practices that receive rural funding.
Afterhours GP/NP/CP Extended consultation: $99
This funding can be claimed when care is provided after 5pm, on weekends or on public holidays.
To cover an additional 15 minutes of GP/NP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation
GP/NP home visit: $126 or RN home visit: $79
This is limited to one per episode of care within 3 days of the initial consult and cannot be claimed on the day of the initial consult.
GP/NP home visit: $126 or RN home visit: $79
This is limited to one per episode of care within 3 days of the initial consult and cannot be claimed on the day of the initial consult.
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of POAC funding.
Respite care is for those patients who require rest home level care rather than hospital level care.
The request for respite care is to be made via the Primary Options team who will then authorise funding for the placement of the patient.
Once funding is approved the practice can then liaise directly with the whanau and respite care providers to determine the most suitable available placement.
Please note:
Contracted respite providers are funded directly through Primary Options. The facility can contact the Primary Options team to confirm funding should they choose, however providing the facility with the patients authorised Primary Options number is sufficient.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient.
The service is funded by Te Whatu Ora.
Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312
Contact Kate Torrie, 06 869 0500 ext 8707, Tairāwhiti DHB Needs Assessment and Coordination Service (NASC), to ascertain the patient's current level of funding/package of care.
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Business rules for the Primary Options Acute Care programme (Tairāwhiti), which supports primary care through funding specific clinical services.
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