✨ Dental Services Compliance and Audit Procedures
4270 NEW ZEALAND GAZETTE No. 151
E7.4
In the event that an audit identifies you have been under-claiming this will be noted in the audit report and you should seek approval from the approving Dental Officer of the District Health Board for reimbursement.
E8 OUTCOMES OF AN AUDIT
E8.1
If, as a result of an audit we have reason to believe that you have not met your obligations set out in this Notice, in addition to any other rights we have under this Notice, we may refer your case to a Complaints Body for investigation.
E8.2
In addition to clause E8.1 we may require that you obtain the approval of the Dental Officer of the District Health Board, in every case, before claiming for payment for any Services outlined in this Notice.
E9 ADVISORY COMMITTEE
E9.1
We may use an Advisory Committee at any time to advise us on any complaints or issues regarding any aspect of this Notice, including any claiming or payment matters or any aspect of your performance of your obligations under this Notice or your delivery of the Services.
E9.2
The Advisory Committee will comprise a chairperson appointed by us and an even number of members:
a. half of whom are to be appointed by us or our agent from nominations made by DHBs and the Ministry, half of these members being Dentists; and
b. half of whom are Dentists who hold a current annual practising certificate and who are to be appointed by us or our agent from nominations made by the NZDA.
E9.3
We agree to meet the costs of the Advisory Committee.
E9.4
Any referral by us to an Advisory Committee is without prejudice to, and does not amount to a waiver of, any other right we have under this Notice. We may withdraw a matter from consideration by an Advisory Committee at any time if the matter becomes subject to an investigation by another Complaints Body or becomes the subject of court proceeding. We will consider any advice or recommendation of an Advisory Committee with an open mind but are not bound to follow any advice or recommendation given.
E9.5
Where any complaint or dispute is referred to the Advisory Committee, both of us agree to assist the Advisory Committee in its enquiry by answering questions, providing information and otherwise. You agree to make available to the Advisory Committee any item which is material to the enquiry, whether or not such an item is specifically requested by the Advisory Committee. Any requirement to make available the clinical records of a Patient will comply with the provisions of the Privacy Act 1993 and the Health Information Privacy Code 1994.
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Online Sources for this page:
VUW Te Waharoa —
NZ Gazette 2003, No 151
Gazette.govt.nz —
NZ Gazette 2003, No 151
✨ LLM interpretation of page content
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Provider Quality Specifications for Oral Health Services
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🏥 Health & Social WelfareAudit, Compliance, Reimbursement, Dental services, Complaints Body, Advisory Committee, Privacy Act, Health Information Privacy Code