Referring a patient for rehabilitation
If your patient is ready for the next steps in their recovery, you can refer them to one of our rehabilitation programmes. You’ll need to get pre-approval from us first.
On this page
Talk to us if you think your patient needs further treatment before they start a rehabilitation programme. You may need to get pre-approval.
Getting pre-approval for treatment
Rehabilitation programmes
We have various rehabilitation programmes that can help your patient with their recovery. This is only for injuries we cover.
Returning to the job they had before their injury
We have a stay at work programme to help your patient get back to their same job. If they need this help, let us know when you complete their ACC18 medical certificate.
You can also get in touch with a Vocational Rehabilitation Service supplier in your region who can organise the referral on your behalf.
Find a stay at work supplier in your area
Recovering from a traumatic brain injury
We have concussion services to help patients with head knocks and brain injuries. You’ll need to complete a referral form.
ACC883 Concussion service referral
ACC7988 Concussion service referral for Te Whatu Ora hospitals
If your patient is a child under 15 years
If you're referring a child or adolescent to the concussion service, you'll need to complete the ACC7412 referral form.
ACC7412 Concussion service referral for a child or adolescent
Find concussion service providers
Search our regional list to find a concussion service provider near you.
Help managing pain from an injury
Our Pain Management Services have been designed for patients who have:
- persistent pain lasting three months or more as a result of the covered injury which is not resolving within normal clinical expectations, or
- a Complex Regional Pain Syndrome (CRPS) diagnosis or a suspected CRPS diagnosis.
Our pain management services include:
- Triage Assessments. This includes an interdisciplinary team review involving psychology and medical practitioners
- assessments by Specialist Pain Medicine Physicians
- Group Programmes
- Community Services, Level One and Level Two. These interdisciplinary pain management programmes can include physiotherapists, occupational therapists, psychologists, clinical pharmacist, medical specialists appropriate for the patient, registered nurses, nurse practitioners, nurse specialists, social workers, dietitians, osteopaths, chiropractors, counsellors.
- Tertiary Delivery Services. These are interdisciplinary pain management services for patients who need tertiary level input. These can include the same interdisciplinary team members as Community Services.
Pain management triage assessment
Your patients will generally need to be referred for a Triage Assessment. This determines the appropriate clinical pathway for them. This may include an ACC-funded Pain Management Service or other services.
A Triage Assessment is required prior to:
- Group Programme
- Community Service level one and level two programmes.
It is optional for Tertiary Delivery Services.
Referrals for a Triage Assessment and for Tertiary Delivery Services can be made by a registered health professional or a rongoā practitioner who is currently providing services to the patient.
You don’t need to get approval from us before referring your patient for a pain management Triage Assessment or for Tertiary Delivery Services.
You will need to complete a referral form for pain management triage assessment.
Provider referral form for a pain management triage assessment (ACC6273)
Pain management suppliers
All pain management suppliers need prior approval from us for any programme they recommend, except Group Programmes.
Suppliers also are responsible for ensuring their patients are eligible for ACC-funded pain management services.
Help at home, with childcare and education services
Let us know if your patient needs help at home, with childcare or education when you complete their ACC18 medical certificate.
Psychology services
If your patient needs a referral to a psychology service, you'll need to ask their recovery team to do this. They may need to organise a psychiatric, neuropsychological or other specialised assessment before they can ask for a referral.
Nursing services
Nursing services are provided:
- to patients who have covered injuries under the Regulations
- through contracted nursing services.
Contracted nursing services
Patients whose needs can’t be met by their primary care teams can make use of contracted nursing services. For example a patient with reduced mobility or a patient with severe or complex injuries.
Contracted nursing services can only be provided on referral and aren’t influenced by patient preference or convenience.
Other rehabilitation services
We offer a range of other services. If you want another rehabilitation service for your patient, ask their recovery team.
Getting pre-approval for a rehabilitation programme
To apply for pre-approval for your patient, you can:
- ask their recovery team to make a referral
- complete the right rehabilitation referral form
- let us know the help they need on the ACC18 medical certificate.
Send the form and other notes to your patient's recovery team
To help your patient get the rehabilitation they need as soon as possible, give their recovery team as much detail as you can. This includes their:
- rehabilitation referral form
- ACC18 medical certificate
- treatment plan
- relevant patient notes.
We’ll let you know our decision
If we approve your request for rehabilitation, the rehabilitation service will contact your patient or their recovery team. You can then arrange the appointment dates and times.
If we decline your patient's referral
We’ll send you a letter if we decline your patient's referral to a rehabilitation programme. The most common reasons are:
- the information was incorrect, or there wasn't enough on the referral form
- the rehabilitation programme isn't suitable in helping your patient's recovery.
Next steps
If you want us to take another look at our decision, you can send us any medical evidence or other relevant information to support your referral.
We'll be in touch to let you know our decision and the next steps for your patient.
If you need help with a rehabilitation referral or to find the right rehabilitation service, contact us.
Contact us
If you have any questions, contact us:
Phone 0800 222 070 (Monday to Friday, 8am to 6pm)
Email providerhelp@acc.co.nz