How do I make a claim?

If submitting electronically

  1. In Medtech, in ‘Advanced Forms’ go to ‘Common Forms’ find and click on ‘Primary Options’, and then ‘OK’.
  2. In the Primary Options screen, select ‘New Referral’, then ‘OK’.
  3. The following screen requires you to tick all boxes to ensure the patient is eligible for the Primary Options Programme. After ticking the boxes, click ‘OK’.
  4. Complete the referral screen including ‘Provisional Diagnosis’, ‘Coding’ (which relates to the provisional diagnosis), and also ‘Add consult notes’ which will automatically add patient notes from Medtech. Consult notes or additional comments may also be typed into the blank box. In the drop down box next to ‘Provider’ select your name. Once all fields are complete, click on ‘Submit referral to Primary Options’.
  5. Finally, in the next screen click on ‘OK’ to save the form.

If submitting manually

Referrals, outcomes and invoicing can also be submitted manually. Forms can be found here. Complete the referral form and fax to the coordinator on 09 438 3210. Remember to also fax through all relevant clinical notes, and also D-Dimer result and Primary Care Decision Rule if the referral is for a suspected DVT.

An outcome must also be submitted at the conclusion of the episode of care. Following submission of the outcome an invoice may be issued to POADMS if you are making a claim. The postal address is: POADMS, c/- Manaia PHO, PO Box 1878, Whangarei.

Outcomes

An outcome must be completed at the conclusion of the episode of care.  After an outcome has been submitted an invoice can also be completed in the system.  Invoicing in the Primary Options system automatically feeds information into Medtech (this appears in the patient’s Daily Record).

Invoicing

If you need to claim for services/consumables, an invoice should be completed in the system. This may only be done once an outcome has been submitted. In addition to submission of the electronic invoice, we require a monthly statement to be issued from Medtech (or other system your practice uses). The statement should be sent to us by the 31st of each month for payment on the 20th of the month following.

When invoicing please ensure you provide enough detail for us to understand what you are claiming for. This includes detailing drugs administered (only non-MPSO funded drugs may be claimed for).

Questions?

Please call the POADMS coordinator for any help.