Telehealth Cancellation Refund Policy

Purpose:

Tamaki Health prides itself in providing accessible and affordable healthcare to its patients. All services rendered to the patients attract a fee payable at the time of the consultation. Consultation fees for Virtual Consultations become payable Online at the time of booking an Appointment. The dynamics surrounding the fees payable, payments made, cancellations and refunds need to be clarified to enable transparency for the patients as well as ease of operations for the Staff members.

Scope:

This policy is applicable to all Tamaki Health Clinics (GP & Urgent Care), providing Virtual Consults by way of Video or Telephone Consultations.

Definitions:

  • Virtual Consultation – A Telephonic or Video Consultation offered to a patient by a Tamaki Health Healthcare Provider
  • Consultation Duration – A normal Consultation is of 10 minute duration
  • Tamaki Health Healthcare Providers – These include, but are not limited to Doctors, Nurses, Clinical Assistants, Case Coordinators, Clinical Family Navigators and Wellness Support Personnel
  • Consultation Charges – Fees payable by a patient for the Virtual Consultation services rendered by Tamaki Health Healthcare Providers
  • Online Charges – Consultation fees payable by a patient for requesting a Virtual Consultation
  • In Clinic Charges – Consultation fees payable by a patient on presenting for a face-to-face Consultation in the Clinic
  • Offline Charges – Consultation fees payable by a patient for requesting an in-absentia Service from a Tamaki Health Clinic such as Repeat Prescriptions, Insurance other reports, etc
  • Invoiced Amount – Fee amount generated and charged to the patients by way of Invoices created in the patient’s file on the Patient Management Software
  • Payment – Fees payable or paid by a patient for the Services rendered to them based on the Invoice generated
  • Refund – Amount of monies to be returned to the patient for failure to render a service or the cancellation of a requested service (eg cancellation of an appointment / procedure)
  • Credit – Amount of monies put into credit on to a patient’s account on their file in the PMS, which could be used for payments for a future service fee
  • Appointment Cancellation – The cancellation of a scheduled appointment with a Tamaki Health Healthcare Provider, which may be done by the Patient or by the Provider / Organisation
  • “Cooling off” Cancellation – An Appointment cancelled immediately up to 2 hours after booking it – this could be due to an error made by the patient or a change of mind
  • “Planned Cancellation” – An Appointment cancelled more than 24 hours before the scheduled Appointment time
  • “Unplanned Cancellation” – An Appointment cancelled between 12 – 24 hours before the scheduled Appointment time
  • Late Cancellation” – An Appointment cancelled less than 12 hours before the scheduled Appointment time
  • Appointment DNA (Did Not Attend) – Patient’s failure or lateness to present for a scheduled appointment / procedure
  • Rescheduling of Appointment – Change in Date or time of a booked appointment to defer it to a later date / time, initiated by either the Patient or by Tamaki Health personnel
  • Breakdown of an Appointment – An appointment that is unable to run the course of its entire duration of 10 minutes due to technical or connectivity issues
  • Termination of an Appointment – An appointment that is discontinued by either the Provider or the Patient, part way through its normal duration

Policy:

General Considerations:

  • All Patient transactions including Invoices, Payments, Credit notes & Refunds must be recorded within the PMS (Medtech Evolution) in the patient file.
  • All Credit Notes & Refunds and any Invoices & Payments with altered charges, must have appropriate annotation describing the reason.
  • Any disputes in relation to charges, payments, credits & refunds will be addressed by the Regional Manager & the Management Team.

Virtual Consultation (Online) Charges:

  • All Virtual Consultations rendered by the various Healthcare Providers for patients aged 14 years and over will attract a fee payable by the patient.
  • The fee structure of the Online Charges can and will be different to the In-Clinic and Offline Charges, due to the nature of the service.
  • The fee structure of the Online charges will be reviewed and adjusted periodically.
  • Fees payable by the various patients will be based on a variety of factors including, Enrolment status, Age, Demographics, Service types (ACC / Medical Consultations).
  • Patients requesting Virtual Consultations via the Online portal will be presented with the applicable Charges at the time of requesting an appointment booking.
  • Appointment confirmation will only be done after the Patient has made the online payment for the service that has been requested.
  • The Consultation charges have been designed to ensure that Tamaki Health Enrolled patients receive services at a lower price compared to Casual and Visitor patients.
  • During the introductory phase the fee structure will be as follows:
    • Enrolled Children under 14 years age: No Charge
    • Enrolled Patients 14 years & over: $10.00 per consultation
    • Casual Patients: $49.00 per consultation
    • There will be no differentiation between the VLCA & non-VLCA patients, or between the other High Needs / non-High Needs categories of patients
    • All Service types (ACC & Non-ACC Services) will be charged at the same rates as above
  • The fees stated in this document relate to a single consultation of 10 minutes duration.
  • If during the course of a Virtual Consultation, a Provider feels that the patient needs to be seen in person, the patient will be asked to present to 1 of the Tamaki Health clinics, and the fees payable by the patient at the clinic will be:
    • Either the difference between that Clinic’s normal consultation for that service, and the fees paid by the patient for the Virtual Consultation, if the face-to-face Consultation fees of that Clinic are higher than the fees paid for the Virtual Consultation.
    • OR, No Additional Consultation fees, if the face-to-face Consultation fees of that Clinic are lower than the fees paid for the Virtual Consultation.
  • After the completion of a Virtual Consultation, if a patient feels the need to be seen at 1 of the Tamaki Health clinics, the fees payable by the patient at the clinic will be:
    • Either the difference between that Clinic’s normal consultation for that service, and the fees paid by the patient for the Virtual Consultation, if the face-to-face Consultation fees of that Clinic are higher than the fees paid for the Virtual Consultation.
    • OR, No Additional Consultation fees, if the face-to-face Consultation fees of that Clinic are lower than the fees paid for the Virtual Consultation.
  • If a patient presents for an In-Clinic Consultation or requests an Offline service at 1 of the Tamaki Health Clinic on the days following the Virtual Consultation, the charges levied will be the fees applicable to the specific type of service / consultation at that clinic, as normal. No special discounts would be applicable.

Cancellations, DNA, Rescheduling:

Cancellations:

  • Upon booking and confirmation of an appointment, a patient may choose to cancel the appointment either immediately or at a later stage.
  • The monies refundable to the patient will be dependent on the duration of time between the cancellation of the appointment and the time of the scheduled appointment
    • A patient can choose to cancel an Appointment immediately up to 2 hours (Cooling off Cancellation) after booking an appointment, and this would not attract any Cancellation fees
    • If a patient cancels an Appointment more than 24 hours (Planned Cancellation) prior to the scheduled Appointment time, there would be no Cancellation fees applicable
    • For Appointments cancelled between 12 – 24 hours (Unplanned Cancellation) before the scheduled Appointment a Cancellation fee of 50% of the Consultation fee would be applicable
    • Cancellations between 0 – 12 hours (Late Cancellations) prior to the scheduled Appointment time will attract a Cancellation fee equivalent to the full Consultation charge that has been paid by the patient

DNA (Did Not Attend):

  • Upon booking and confirmation of an appointment, a patient is expected to connect and be present for the Virtual Appointment session 5 minutes before the scheduled Appointment time
    • If a patient fails to present for the scheduled Appointment 5 minutes after the commencement of the scheduled Appointment, the patient will have been considered not to have attended and the Appointment will be cancelled as a DNA (Did Not Attend)
    • If a patient fails to present for the scheduled Appointment altogether, the patient will have been considered not to have attended and the Appointment will be cancelled as a DNA (Did Not Attend)
  • All DNAs will attract a Cancellation fee equivalent to the full Consultation charge that has been paid by the patient
  • Some DNAs which may occur due to emergent circumstances, may qualify for a Credit of the Consultation fee, but would need to be evaluated on a case by case basis
  • Should a patient wish to book a fresh appointment due to their DNA, they can choose to do so, but will have to pay the full Consultation fee as applicable

Rescheduling / Rebooking:

  • Upon booking and confirmation of an appointment, a patient may choose to reschedule the appointment either immediately or at a later stage, due to change in circumstances
    • Rescheduling of an Appointment done immediately upon booking an appointment will not attract any change / cancellation fee, and patient would not be expected to pay any additional fees
    • Rescheduling of an Appointment done between 0 – 12 hours prior to the scheduled Appointment time will attract a Cancellation fee equivalent to the full Consultation charge that has been paid by the patient
    • Rescheduling of an Appointment done between 12 – 24 hours before the scheduled Appointment a Cancellation fee of 50% of the Consultation fee would be applicable
  • The monies refundable to the patient will be dependent on the duration of time between the cancellation of the appointment and the time of the scheduled appointment.
  • Any rescheduling of Appointment done at the scheduled Appointment time would be considered a DNA. No credit or refunds would be available to the patient.

Doctor Unavailable:

  • Sickness, personal emergent circumstances and other unforeseen events can lead to a rostered Doctor not being available for a Scheduled Appointment Session.
  • In the event that a Doctor is unavailable to attend a Scheduled Appointment Session, the Virtual Clinic Administrative Staff will:
    • In conjunction with the Roster team, ensure the availability of a replacement Doctor to manage that planned session.
    • Get the Appointment book for the replacement Doctor opened
    • Contact the various Patients who have scheduled Appointments and inform them of the change in the Doctor with the option to, either be attended to by the replacement Doctor, or to reschedule the Appointment to a different day and time when the original Doctor is next available.
  • If the patient is willing to be attended to by the replacement Doctor, there will be no change to the charges that the patient has already paid.
  • If the patient wishes to reschedule the Appointment to a different day & time to be attended by the original Doctor, the charges paid by the patient will become applicable to the rescheduled Appointment. There will be no additional charges levied.
  • If the patient neither wishes to be attended to by the replacement Doctor, nor reschedule the Appointment, the patient can choose to cancel the Appointment, the fees paid by the patient will be fully refunded.

Breakdown & Termination of an Appointment:

  • In the event of an IT / connectivity / technical failure during the course of a Virtual Consultation, the Provider needs to phone the patient, inform them about the technical issue and offer to reschedule / rebook the Appointment at the next available time at no extra cost to the patient.
    • If the patient does not wish to reschedule / rebook another Appointment, the current appointment will be considered as a “failed” encounter and patient would be refunded the full Consultation fees
  • The rapport between a patient and a Provider could breakdown during the course of a Consultation, owing to a variety of factors, including demands for Controlled Medications, unrealistic patient expectations or interpersonal differences. In the unlikely event of a breakdown in the rapport between the patient and the Provider, during the course of a Virtual Consultation, the Provider will gently inform the patient of the need to terminate the Consultation
    • For Terminated Consultations, fees paid by the patient may be partially or fully refunded on a case by case basis. The decision to refund the monies or not would be at the discretion of the Provider concerned and the Senior Management team

Credit & Refund:

  • All monies that need to be refunded to the patient must be recorded on the patient’s file in the PMS, by way of relevant Credit notes associated with the appropriate refund amount.
  • The refunds will be made directly into the patient’s account that was linked to the Online payment gateway.
  • A patient can choose to leave the amount paid as a Credit balance in their account on the PMS, for use towards future Consultations.
  • All Refunds will be processed by the Claims Processing Unit of Tamaki Health.
  • If the patient has chosen to receive a refund, the refundable amounts will be as follows:
    • “Cooling off Cancellation” – 100% (Full) refund
    • “Planned Cancellation” – 100% (Full) refund
    • “Doctor unavailable” Cancellation – 100% (Full) refund
    • “Failed Encounters” – 100% (Full) refund
    • “Unplanned Cancellation” – 50% refund
    • “Late Rescheduled Appointment” – 50% refund
    • “Last minute Rescheduling of Appointment” – No refund
    • “Late Cancellations” – No refund
    • “DNA” – No refund
    • “Terminated Consultations” – TBD