Amending Your Patient Fees

This Year's Annual Statement of Reasonable Fee Increase

For the 2024-2025 period, the Annual Statement of Reasonable Fee Increase (ASRFI) is 7.76% for practices with 50% capitation funding. This percentage differs depending on your capitation revenue split. The Annual Statement does not apply to Very Low Cost Access Funded (VLCA) practices, as they receive extra funding for their enrolled patient base and in return have set their fees below this threshold. This year, there is also a new consideration for adult patient fees over $65.00. If you have any ‘banked’ unused percentage from previous years, add this to this years ASRFI to get your Total ASRFI.

Where any fee increase exceeds the Total ASRFI and the adult patient fees are more than $65.00 (incl.GST), Health NZ will consider the increase closely. In such cases, the practice may be contacted to provide further information on the context of the increase, before any decision to formally refer to the Fees Review Committee (FRC) is made. The Committee's role is to make recommendations about whether the fee increases are fair and reasonable to patients and providers. If the Amendment is justifiable, the FRC is likely to determine it reasonable. All FRC decisions are recommendations only.

Co-payment Adjustment Template

To ensure the application of the Annual Statement reflects an individual practice’s situation Health New Zealand provides a Co-Payment Adjustment Template. This template calculates your ASRFI based on your patient numbers and can show your increased fees as a percentage of change in revenue.

Practices do not need to fill out this template themselves. WellSouth will handle this process on your behalf. The template is provided solely for your transparency and interest, allowing you to see the calculations if desired.

Notification for Increasing Fees: Fees Amendment Form

Any fee changes for enrolled patients are to be notified to WellSouth and Health NZ as soon as practical, and preferably before the increase takes effect. In any case, notification to WellSouth must be made within 2 weeks of the fee increase taking effect.

Important Information:

• It may take WellSouth up to 5 working days to process your request. 

• WellSouth will confirm via email once we have sent Health NZ your Fee Amendment notification.

• Health NZ have up to 20 working days after they receive notification of the Fees Amendment, to refer an increase to the FRC.

• If you do not hear from either WellSouth or Health NZ within 20 working days after receiving our confirmation email, your fee increase is considered reasonable.

   

Please submit your completed Fees Amendment Form to practicenetwork@wellsouth.org.nz.