New Zealand Gazette – 2002 – No. 40

Page 1129

✨ Maternity Services Claims Processing



24 APRIL

NEW ZEALAND GAZETTE

1129

This rule will apply unless, in its sole discretion, the Ministry of Health considers
there were circumstances beyond the control of the Authorised Practitioner that
prevented the Claim being submitted any earlier.

5.3.5 Where a Claim has to be returned to the Authorised Practitioner or Organisation
for correction of claiming details in accordance with clause D5.2.5, the timeframe
in clause D5.3.3 will be applied from the date the Claim was initially received by
Health Benefits.

6.0 RECORD KEEPING

6.1 Where the Authorised Practitioner claims any Maternity Services, s/he shall ensure a
comprehensive, legible and readily accessible record is kept for every woman and baby,
which shall include the following:

(a) the date and time on which the service was provided;

(b) the place where the service was provided;

(c) the name, birth date and usual place of residence of the woman and baby;

(d) the NHI number of the woman and baby;

(e) a record of the clinical history of the woman and baby, services rendered, type and
amount of pharmaceuticals prescribed, type and number of any laboratory
diagnostic services requested;

(f) details of any Specialist referrals made or received; and

(g) any other information required as detailed on the claim forms in Appendix VII.

6.2 The Authorised Practitioner will keep all records required by this Notice for a period of at
least ten years or as provided in the Health (Retention of Health Information) Regulations
1996.

7.0 AUDIT

7.1 The Ministry of Health will conduct audits of Authorised Practitioners in accordance with
the protocols agreed between the Ministry of Health and either the New Zealand College
of Midwives or the New Zealand Medical Association.

7.2 The Ministry of Health’s right to audit under this clause continues after this Notice ends
but only to the extent that it is relevant to the period during which the Notice was in force.

7.3 Where there is audit evidence of partial service delivery, the Ministry of Health may obtain
a partial repayment of the service fee.



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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 2002, No 40


Gazette.govt.nz — PDF NZ Gazette 2002, No 40




✨ LLM interpretation of page content

🏥 Processing of Claims for Maternity Services (continued from previous page)

🏥 Health & Social Welfare
Claims, Maternity Services, Payment, Registration, Authorised Practitioner, Record Keeping, Audit