Summary of Covid-Related Claims Processes (13th Dec)

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Summary of Covid-Related Claims & Processes

13/12/2021

To support recent updates around claiming for Covid-related activity in general practice recently this, please see the below summary of the various claiming types and processes for these: Claim Type

Amount inc. GST

Eligibility

Claim Via

Swab-based Activity (inc. Asymptomatic Assessments + Swab, Virtual Consults, Simple Assessments (+/- Swab), Full Assessments + Swab)

Halcyon $69 $138 $287.50

For guidance and flowchart on these claims click here.

As activity occurs. Payments made on monthly cycle. For guidance and flowchart on these claims click here.

Other Covid-Related Claims: Halcyon Claim Form under development. Interim Claim Process is a manual spreadsheet. Process below. Send completed spreadsheet monthly by email to: GPSAdmin@wboppho.org.nz Practice payment against 1 batch invoice per month. Copies of individual invoices not required.

‘Quick Call’ by Nurse (inc. Vaccine Hesitant Pts & Encouraging eligible Boosters)

$23

Pre-Vaccination Consultation (inc. consults for Pfizer 1st and 2nd primary dose to encourage uptake & discuss patient concerns)

$69

AstraZeneca Consultation (inc. consults for 1st and 2nd Primary Dose & Booster. Please see clinical guide for advice on when consult + prescription is required.)

Post–Vaccine Consult: Adverse Event (inc. Virtual/in person limited assessment + in-person full assessment)

3rd Primary Dose for Immunocompromised (inc. Virtual/In-person consult + Prescription, Consult, no prescription/patient declined)

Temporary Vaccine Exemption Consult (inc. Standard (no exam) and Complex (with exam)

Māori, Pasifika, CSC Holder (or ‘Other’ as per clinical discretion)

Māori, Pasifika, CSC Holder (or ‘Other’ as per clinical discretion)

All Patients $69

AsraZeneca Clinical Guidance Document here.

Virtual/In Person Limited Assessment: $69 All patients In-Person Full Assessment: $138 Virtual Consult – Simple, Consult - no prescription, Consult - pt declines: $69

Age 12+ severely immunocompromised patients.

In-person Consult Complex: $138

For clinical guidance document click here.

Standard (no pt exam): $69 Complex (full pt exam): $138

Specified exemption criteria. For Clinical Guidance (including application form) click here.

Claim as ‘Quick Call’ in Manual Excel Spreadsheet. Claim as: ‘Pre-Vaccination Consult’ in Manual Excel Spreadsheet.

Claim as: ‘Pre-Vaccination Consult in Manual Excel Spreadsheet. Type ‘Yes’ in ‘AstraZeneca’ Column. Claim as: ‘Adverse Event – Limited OR Full’ in Manual Excel Spreadsheet.

Claim as: ‘Third Dose Virtual OR In Person’ in Manual Excel Spreadsheet.

Claim as: ‘Vaccine Exemption - In Person No Examination OR Full Examination’ in Manual Excel Spreadsheet.


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