Category 8 - MISCELLANEOUS SERVICES
Under the Medicare program collaboration is having arrangements in place with a medical practitioner/s to consult, refer or transfer care as clinical needs dictate, to ensure safe, high quality maternity care. Under Medicare a collaborative arrangement can be with any medical practitioner.
Collaborative arrangement can be established in the following ways:
a) being employed or engaged by 1 or more specified medical practitioners or by an entity that employs or engages 1 or more specified medical practitioners; OR
b) receiving patients by referral in writing to the nurse practitioner for treatment from a specified medical practitioner, OR
c) having a signed written agreement with one or more specified medical practitioners, OR
d) having an arrangement with and acknowledged by at least one specified medical practitioners. This includes keeping comprehensive notes on all instances of consultation, referral and transfer of care, diagnostic tests requested and the test results and providing the collaborating practitioner/s with those results.
The legislation requires that collaborative arrangements must be in place at the time the participating nurse practitioner provides the service. The legislation requires that for each kind of collaborative arrangement, at least one medical practitioner is needed; it is not possible for the nurse practitioner to have a collaborative arrangement with an entity such as a health service.
a) Being employed or engaged by a medical practice or an entity
An entity may refer to a hospital or community health centre. For a nurse practitioner to have a collaborative arrangement in these circumstances, that nurse practitioner must be employed or engaged by an entity that also employs or engages 1 or more specified medical practitioners.
The terms employ or engage covers both employees and contractors. This will cover an eligible nurse practitioner who is employed or engaged by a medical practice so long as that medical practice employs or engages at least one medical practitioner.
There must be at least one specified medical practitioner employed or engaged by the entity each time the nurse practitioner renders a service/performs treatment. However, there is no requirement that the consultation, referral or transfer of care must always be to the medical practitioner(s) employed/engaged by the entity.
b) Referral from a medical practitioner
A participating nurse practitioner's patient will be able to access the MBS and PBS if a patient has been referred in writing to the nurse practitioner by a specified medical practitioner. The arrangement must provide for consultation, referral and transfer of care should the clinical need arise.
c) Written agreement with a medical practitioner
A nurse practitioner's patient will be able to access the MBS and PBS if the nurse practitioner has a written agreement in place with one or more doctors. The agreement must be signed by the nurse practitioner and a doctor. The arrangement must deal with consultation, referral and transfer to a doctor.
d) Arrangement with, acknowledged by a medical practitioner.
Evidence of 'acknowledgement' by a medical practitioner for each patient for whom the nurse practitioner provides care is a requirement to ensure that the medical practitioner being named understands and accepts the collaborative arrangement.
The acknowledgement does not have to be obtained on an individual patient basis. This means that, for example, a nurse practitioner could obtain an acknowledgement from a specified medical practitioner that he or she will be the collaborating medical practitioner for some or all of the nurse practitioner's patients. Arrangements to collaborate could be obtained in a number of ways including signing of documents, email or fax confirmation, or verbal acknowledgement which the nurse practitioner documents in their written records.
The nurse practitioner is required to record in written records any communications in regard to consultations, referral and transfer of the patient's care with the medical practitioner, including information that has been forwarded to the medical practitioner. The nurse practitioner is also required to send a copy of all pathology and diagnostic imaging results to a named medical practitioner and to record in the nurse practitioner's written records when this occurs (however, there is no requirement that the nurse practitioner consult with a medical practitioner in relation to every test result). The purpose of sharing records with the collaborating medical practitioner is to prevent duplication of services and to ensure continuity of care.
Arrangements to collaborate could be obtained in a number of ways including signing of documents, email or fax confirmation, or verbal acknowledgement which the nurse practitioner documents in their written records.
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change