This service is designed to ensure low acuity presentations to ED are actively redirected back to primary care. The initial consultation fee is funded for eligible patients.
In the first instance, ED will contact the patient’s registered general practice to determine if there is an appointment available. Should an appointment not be available ED will contact one of the contracted overflow providers, currently Medicross and Phoenix Urgent Doctors to determine if there is capacity to see the patient.
ED will not redirect a patient unless the receiving practice has accepted them.
For conditions that meet Primary Options Acute Care criteria, practices can then initiate a referral and claim via the usual Primary Options Acute Care processes.
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 Pinnacle practices in Taranaki region can claim for this service.
Patients who have not been actively referred from ED
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
Prices listed below are GST inclusive.
When opening a referral please select the ‘referral initiated by’ option ‘ED’
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 ED Redirect.
All ED redirect initial consults can be claimed for by selecting the ED GP/NP consultation regardless of whether the patient meets the Primary Options Acute Care criteria or not.
ED Redirect GP/NP Consultation $85.00
This invoice funds the initial consultation for the redirected patient.
ED Redirect GP/NP Consultation after hours $95.00
This invoice funds the initial consultation for the redirected patient after 5pm on a weekday, weekends and public holidays
ED Redirect Sundries Variable
This requires an itemised list of any extra changes incurred by the patient
Once the patient is at the practice, the GP/NP will assess the patient and determine whether the condition meets any Primary Options Acute Care criteria or is considered normal GP business/non-acute.
If the patient meets Primary Options Acute Care criteria, please claim the above invoices to cover the cost of their initial consultation and continue to claim as you normally would for a Primary Options Acute Care case.
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.
Once the episode of care is completed and the patient is no longer acutely unwell, they exit the POAC programme.
Once the patient exits the POAC programme, the case requires a clinical outcome to be lodged. No payment can be made for any claims unless the outcome is completed.
Where treatment in the community is no longer clinically appropriate, the patient may be admitted to hospital during a POAC plan of care. Please indicate this in the clinical outcome.
No co payment is to be charged to the patient.
The service is funded by Taranaki DHB.
Primary options team, Pinnacle Midlands Health Network
0800 646 764