ACC claim status
Scenario
Bob goes to the doctor with an injury. The doctor originates a claim, refers Bob to a Physiotherapist and submits the claim to ACC
Bob attends Physiotherapy the next day and returns 2 days later for a follow-up appointment.
ACC review claim and 1-week later place the claim on hold pending investigation. They do not inform the Physiotherapist
The Physiotherapist subsequently invoices ACC for the initial appointment plus 1 follow-up.
The 2nd follow-up is scheduled for week 2 and the 3rd at the end of the week.
End of week 2 the Physiotherapist invoices ACC for the 2nd and 3rd follow-ups.
The Physiotherapist finds out the claim is on hold when the payment is declined with the reason "Claim under investigation" or "Claim declined"
The claim is on hold for 3-months while ACC make a decision.
ACC inform the client that the claim in declined. They do not inform the Physiotherapist.
The Physiotherapist has no way to record the claim is on hold or declined other that making a note "somewhere".
Question
Is it possible for an option to be added to the Condition screen that would allow a status of "On Hold", "Under Investigation" or "Declined" to be selected.
All these options should alert the user that the status of the claim is not 'normal' and prevent an appointment being made on the claim number without a conscious decision being made.
Background
Claims are sometimes put on hold by ACC. The reasons for this action are many and varied, ranging from late submission of a claim to incorrect claimant details to questionable circumstances. This caution is justified.
The Physiotherapist in this case are not aware of these actions until the payment for services provided is withheld by ACC. ACC do alert the client but very rarely will the client alert the provider. This means that the Physiotherapist incurs a cost that, if the claim is declined, needs to be recovered from the client.
We find out the status of the claim when we receive the payment schedule ie after the fact.
ACC will, in some circumstances, pay our costs up to the date the claim was put on hold or up to the date the decision was made. Getting this information from GPM is not straight forward. ACC want to know schedule numbers, they have limited time and usually there are a number of issue to discuss with them. If there was a status option on the condition, then a report could be created "Appointments invoiced, not paid where Condition status not equal to "good to go"!"
I will copy this to the forum but would appreciate some feed back especially if this has been resolved already.
Hi
Thanks for sending your suggestion through.
It should be fairly straight forward to report on charges sent to ACC which have not been Paid or are set to Held, so that these can be communicated to ACC.
Can you please contact our Support Team by submitting a ticket or by emailing support@gensolve.com and they will be able to advise.
Regards
Nikki