Background
Historically it has not been part of POAC’s remit to fund unavoidable admission i.e. admissions where, from the initial community assessment, it is clear that hospital evaluation is required.
In the current environment, delays in ambulance services continue to increase. This is particularly concerning with winter pressures and places additional resource issues on primary care facilities.
What's changing
POAC funding has been extended to patients who are in a healthcare facility and:
- a delay occurs in the arrival of an ambulance to transfer acutely to hospital; PLUS
- active monitoring is required
Claiming and supporting documentation
Submit your referral in the normal way via the POAC PMS Form, use the initial referral code "St John Ambulance Delay - awaiting transfer to hospital (as per policy)".
Submit the claim using the code "Ambulance delay - active monitoring" from the fee schedule. Claim additional services (e.g. IV fluids, ECG, etc.) required for stabilisation during this period.
POAC will accept claims where the wait for an ambulance has exceeded 30 minutes. Clinical documentation, including time stamps, demonstrates active monitoring beyond 30 minutes whilst awaiting ambulance arrival.
All referrals will be assessed per standard processes, additional information may be required on a case-by-case basis.