✨ Health Service Payment Policies
13 APRIL 2007 NEW ZEALAND GAZETTE, No. 41 1057
CC8
Payment of claims
(1) HealthPAC will pay a claim within 22 working days from the receipt of a valid claim.
(2) Payment will be made by way of direct credit.
(3) If a claim has to be returned to the maternity provider for correction of claiming details and a corrected claim has been submitted by the maternity provider, the corrected claim will be paid based on the date of receipt of the corrected claim, not the date of receipt of the initial claim.
(4) If a claim for a primary maternity service is received more than 6 months after the service has been completed, there will be a 10% fee deduction.
(5) No claim for primary maternity services will be paid if the claim is received more than 12 months after the service has been completed.
(6) Subclauses (4) and (5) apply unless, in its sole discretion, the Ministry of Health considers there were circumstances beyond the control of the maternity provider that prevented the claim being submitted any earlier.
Defined in this notice: claim, maternity provider, primary maternity services
CC9
Set-off
(1) If the Ministry of Health determines that a maternity provider has been overpaid or that a maternity provider was not entitled to a payment, or any part of a payment, the Ministry of Health may deduct any over payment from any subsequent payment payable to that maternity provider.
(2) Before making any deduction, the Ministry of Health will advise the maternity provider of the proposed deduction and give the maternity provider—
(a) the reason for the deduction; and
(b) enough time to request the Ministry of Health to reconsider the deduction.
Defined in this notice: maternity provider
CC10
Reconsideration of claim
A maternity provider may, within 3 months from the date on which they receive advice of the outcome of a claim, request, in writing, that the Ministry of Health reconsider the claim.
Defined in this notice: claim, maternity provider
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Online Sources for this page:
VUW Te Waharoa —
NZ Gazette 2007, No 41
Gazette.govt.nz —
NZ Gazette 2007, No 41
✨ LLM interpretation of page content
🏥
Basis for Claiming Under Maternity Service Notice
(continued from previous page)
🏥 Health & Social WelfareClaims, Maternity Provider, Manual Claims, Online Claims, Electronic Claims, HealthPAC, OMC, HealthLink Network
🏥 Payment of Claims for Maternity Services
🏥 Health & Social WelfarePayment, Claims, Maternity Provider, HealthPAC, Direct Credit, Fee Deduction
🏥 Set-off for Overpayments to Maternity Providers
🏥 Health & Social WelfareOverpayment, Deduction, Maternity Provider, Reconsideration
🏥 Reconsideration of Claim for Maternity Services
🏥 Health & Social WelfareReconsideration, Claim, Maternity Provider, Written Request