New Zealand Gazette – 2005 – No. 55

Page 1405

✨ Health Services Claims



23 MARCH 2005
NEW ZEALAND GAZETTE, No. 55
1405

PART E: CLAIMS

E1. Claims

E1.1 Provided that the Eligible Person has an Entitlement Account pursuant to clause D2, the Ministry will accept Claims from:

(a) any Provider where that Provider provides the Services to an Eligible Person and makes a Claim for payment in accordance with clause E3; or

(b) an Eligible Person where he or she purchases the Services from any Provider and makes a Claim for payment in accordance with clause E4.

E1.2 A Provider may only make a Claim under clause E3 if the Eligible Person agrees.

E2. Persons Not Eligible

E2.1 The Ministry will not accept Claims from:

(a) a Provider for providing the Services to a Person who is not an Eligible Person (“Non Eligible Person”);

(b) a Non Eligible Person who purchases the Services from any Provider; or

(c) a Provider to whom clause B11.4 applies.

E3. Provider Claim Process

E3.1 The Provider must claim for the payments in accordance with the following process:

(a) The Provider must provide the Services to the Eligible Person in accordance with this Notice.

(b) The Provider must provide Eligible Persons with a Proof of Purchase for the Services.

(c) The Provider must submit to HealthPAC:

(i) a Claim Summary Form completed by the Provider;

(ii) a Wigs and Hairpieces Claim Form completed by each Eligible Person to whom the Provider provided the Services for which the Provider is making the Claim; and

(iii) a Proof of Purchase for the Services provided to each Eligible Person.

E4. Eligible Person Claim Process

E4.1 An Eligible Person must claim for the payments in accordance with the following process:

(a) After receiving the Services, the Eligible Person must obtain a Proof of Purchase from the Provider in accordance with this Notice.

(b) The Eligible Person must obtain a Wigs and Hairpieces Claim Form from that Provider or, where that Provider is not located in New Zealand, from HealthPAC.



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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 2005, No 55


Gazette.govt.nz — PDF NZ Gazette 2005, No 55




✨ LLM interpretation of page content

🏥 Claims Process for Health Services (continued from previous page)

🏥 Health & Social Welfare
Health Services, Claims, Providers, Eligible Persons, Payment Process