Maternity services payments

The maternity services payments are claimed by authorised doctors, midwives and specialists to reimburse them for all maternity related-services. New Zealand women are not charged for their maternity care.

What is the background to the Primary Maternity Services Notice 2007?

The Ministry of Health has undertaken the project PMO0170 Primary Maternity Service Notice 2007. This project resulted in the Primary Maternity Services Notice 2007 being implemented. This new Notice will provide updated business rules, service specifications and quality. The MOH implemented this Primary Maternity Services Notice effective from 1 July 2007.

What is the business opportunity and strategic alignment of the Primary Maternity Services Notice 2007?

The implementation of the Primary Maternity Services Notice provided Sector Services with an opportunity to improve the systems and processes used to capture and process Primary Maternity Service registrations and claims whilst also delivering the changes which have been identified within the new Notice.

What are the objectives of project?

  • To ensure that Maternity Providers are authorised to claim under the Primary Maternity Services Notice 2007.
  • To ensure that the printed forms supplied to authorised Maternity Providers reflect the registration and claiming requirements of the Primary Maternity Services Notice 2007.
  • To ensure the following systems are modified and/or enhanced to support the registration and claiming requirements of the Primary Maternity Services Notice:
    • Proclaim Maternity Claim system
    • Sector Services On-line Maternity Claim system
    • Practice Management Systems
    • HL7 Electronic Messaging – Maternity Specification
    • Sector Services Interface to NZHIS MNIS data warehouse
    • Updating Sector Services’s CMS system with new agreements and the new Purchase Units and Fees payable under the Primary Maternity Services Notice 2007.
  • To ensure that Maternity Providers receive guidelines on how to claim under the Primary Maternity Services Notice.
  • To communicate clearly to Maternity Providers, the changes Sector Services has made to the Registration and Claim processes and systems.

How many claim forms can I attach to a Maternity Claim Summary form?

There is no limit to the number of claim forms submitted for processing. Please ensure that all forms are securely attached to each other.

How do I know if a woman has been registered?

Please phone the Sector Services Contact Centre on 0800 458 448 and they can tell you if a woman has been registered but the Privacy Act prevents them from saying who the lead maternity carer is.

Why did my claim get sent back?

A letter is enclosed with your returned claim forms – the second paragraph of this letter will detail the reasons for the rejections and in most cases the errors are highlighted on claim.

How do I get my claims paid on time?

Ensure that all information supplied on the claims forms is correct and that all the required information has been included. If you are using computer generated forms make certain they provide all the information that a standard Sector Services form has and that they are in an easy to understand format. If you have any queries about the claim form requirements please phone Sector Services’s Contact Centre.

How long will it take for my maternity claims to be paid?

Payment turnaround is based on the way Sector Services receives your claims.

  • If you send your claims through electronically they will be processed and paid within 10 working days of receipt.
  • If you send your claims on paper they will be processed within 22 working days of receipt.

How do I become a maternity provider?

Write to or contact:

Sector Services
Private Bag 1942
Dunedin

Phone: 0800 281 222

to request an Application form for a Section 88 Maternity Advice Notice. A covering letter and application form will then be sent to the Provider to complete and return to Sector Services for processing. Once your application has been approved and processed accordingly, the Provider will be issued with a Payee number, Agreement number and a Section 88 Maternity Advice Notice.

Where should I send my claims?

Send all completed claim forms to

Maternity
Sector Services
PO Box 1026
Wellington

I have run out of claim forms/application forms, where can I get some more?

Claim forms are available free from Wickliffe Press on 0800 259 138 – you will need to provide your payee number.

Please note: you should not rely solely on the answers provided here; the contracts applicable to each provider and all relevant legislation must be consulted to determine the full rights & liabilities applicable to any service provider or funder.

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