The St John redirect service provides the opportunity, where clinically appropriate, for St John to seek general practice intervention and avoid unnecessary emergency department utilisation.
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.
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
When opening a referral please select the 'referral initiated by' option 'St John'.
For conditions that meet Primary Options Acute Care criteria, please continue with the usual Primary Options Acute Care processes.
For conditions that do not meet Primary Options Acute Care criteria, please set the pathway/coding to St John redirect.
All St John redirect initial consults can be claimed for by selecting the St John redirect consultation or St John redirect ACC surcharge, regardless of whether the patient meets the Primary Options Acute Care criteria or not.
Prices listed below are GST inclusive.
St John redirect consultation: $79
This invoice funds the initial consultation for the redirected patient.
St John redirect ACC surcharge: $47
This invoice funds the ACC surcharge for the redirected patient if their condition is ACC related.
If the patient meets Primary Options Acute Care criteria, please claim one of the above invoices to cover the cost of their initial consultation and continue to claim as you normally would for the treatment provided to the acutely unwell patient who is safe to manage in the community.
No patient co-payment can be charged to the patient; however, the patient is responsible for funding the cost of the ambulance fee.
Repeat claims
The practice may claim for the same patient for more than one episode, as long as the patient had been redirected by St John in each instance.
Following initial redirection – cost of transport to hospital
If the redirected patient’s condition has not improved with treatment or has deteriorated and the patient now requires transport to hospital via ambulance, please contact the Primary Options team for details on the cost of the second ambulance fee and who is responsible for funding it.
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of POAC funding.
It has been recommended that in addition to a good assessment and history, the full range of appropriate observations should be documented, especially where the diagnosis is undetermined. It is important to state the time of consultations and interactions with the patient.
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.
Jackie Clapperton, St John nurse practitioner
06 868 7315
Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312
Business rules for the Primary Options Acute Care programme (Tairāwhiti), which supports primary care through funding specific clinical services.
Quick guides to assist practices with identifying eligibility criteria;invoices that can be claimed; managing claims and providing assistance with understanding remittance reports
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