Insulin initiation

Any practice in Tairāwhiti region can offer and claim for this service.

• This programme is an inclusive one-off payment for all time spent with clinicians and supplying consumables.
• Referrals can be initiated by a registered nurse or GP and must include related clinical notes. 
• Only one referral per patient can be submitted. 
• Each referral can contain a maximum of one initial and one follow up claim. 

• People with type 2 diabetes who require insulin initiation and are enrolled in a Pinnacle practice.
• People that are eligible for New Zealand funded health care. 

• Patients domiciled in Te Whatu Ora Tairāwhiti area.

• Please note this funding is not available for patients starting on dulaglutide (Trulicity).

People who are already on insulin and need their insulin doses titrating as part of their ongoing care, or changing their type of insulin use, are ineligible for funding under this pathway. 

Patients not domiciled in Te Whatu Ora Tairāwhiti area.

This funding is not available for patients starting on dulaglutide (Trulicity).

• The episode of care ends when the outcome and claim are submitted.
• Payment will be made once an outcome has been lodged for the case.

Please note this funding is not available for patients starting on dulaglutide (Trulicity).

Initial insulin start 

• Includes consult time and any consumables $92.70 (GST inclusive).  
• Maximum of one per patient. 

Insulin start follow-up 

• Includes consult time and any consumables $51.50 (GST inclusive).
• Maximum of one per patient.  

Submit the referral including the notes for the initial insulin start consultation and use the 'invoice only' to claim the initial insulin start.

The practice will receive a reminder to close the case by submitting an 'outcome'; this can serve as a prompt to check if the patient has had their face to face follow-up consultation.

If the patient has had a follow-up consultation, submit the 'outcome and invoice' form including the follow-up consultation notes and add the insulin start follow-up claim in the invoicing section of the form. This will close the case and payment will be made. 

Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding. 

• No co-payment can be charged for insulin start or insulin follow up. 
• Any further follow up can be charged to the patient but please make sure the patient is aware of this.

The service is funded by Te Whatu Ora.