ACC GP MRI service

Any Pinnacle practice who has an accredited GP/NP(s) using these referral pathways can claim for this service.

Pinnacle is responsible for providing accreditation (practical training) for GP/NPs to use the ACC GP MRI referral pathways. Their role is also to support referrers and radiology providers through the referral process, to manage service quality through clinical governance and audit functions and reimburse GP/NPs for the services they provide. 

GP/NPs must complete practical training in order to be accredited to use these referral pathways. All referrals must be made via Profusion.  Outcome data required by the ACC contract must be completed within your PMS. A claim for services provided can be made at the same time as outcome data is provided.

All patients who meet the eligibility criteria of the pathway can have access to this service. 

The four clinical pathways can be accessed via the ACC GP MRI toolkit. 

Patients who do not meet ALL eligibility criteria for a pathway cannot access this service.

1. The ACC GP MRI outcome must be completed in Profusion for each referral before payment will be made.
   
   
2. The episode of care is complete once the patient has been consulted regarding the treatment journey moving forward post MRI.
   
   
3. A patient may access the clinical pathways for more than one injury site OR for the same injury site more than once if this is a new injury to the same site.

The potential service fee that can be claimed:

• GP extended consult (claimable with each MRI completed): $122.00 (GST included) (Increase effective from 1 July 2023).

Outcomes must be completed by a GP or nurse at the practice. To receive payment for an MRI referral, the outcome needs to be added to the request in Profusion. 

If you have any problems processing the outcome for a patient please contact the Profusion helpdesk team on 09 374 6759. 

Referral data must be provided as per the referral template in Profusion. 

Clinical notes in the form of outcome data template completion is required. (Detailed instructions included in practical training session).

The patient will pay the original consultation fee (ACC). The patient will not be charged for the consultation post imaging which will explain the treatment journey moving forward.

The service is funded by ACC.