What is ACC and does it cover my orthopaedic treatment?

ACC (the Accident Compensation Corporation) provides no-fault personal injury cover for all New Zealand residents and visitors. If your injury and surgery are accepted by ACC, the costs of your care and recovery are covered, regardless of whether you also have private health insurance.

Do I need a referral to see Dr Boyle for an ACC injury?

Yes. A referral from a GP, physiotherapist, or other registered healthcare practitioner is required before ACC will fund your specialist assessment. Ask your healthcare provider to refer you specifically to Dr Matthew Boyle at Auckland Bone and Joint Surgery. Referrals can be sent via HealthLink EDI: drmboyle.

Does ACC cover my initial consultation and imaging?

Yes. The cost of your initial assessment with Dr Boyle is fully covered by ACC, as are any special investigations such as MRI or CT scans that are requested as part of that assessment.

How long does ACC take to approve surgery?

Once you decide to proceed with surgery, Dr Boyle submits an Assessment Report and Treatment Plan (ARTP) to ACC on your behalf. Straightforward injuries, such as an ACL tear, are usually approved within 2 to 3 weeks. More complex conditions, such as rotator cuff tears or hip injuries, can take up to 8 weeks for a decision.

What happens if ACC declines my surgery request?

ACC covering your initial assessment does not guarantee your surgery request will be approved. If ACC declines your ARTP, you will receive a letter outlining your options, which may include lodging an appeal, using private health insurance, self-funding, or being referred into the public health system. ACC will fund one additional clinic visit to discuss this with Dr. Boyle even if your surgery has been declined.

Can I use private health insurance instead of ACC?

Yes. If you have private health insurance and don't want to wait for an ACC appeal outcome, you can proceed with surgery through your insurer and pursue the ACC appeal at the same time. Your insurance company can guide you through that process.

Can I appeal an ACC decision?

Yes. If your ARTP is declined, you have the right to lodge an appeal. The appeal process generally takes around 3 months to complete.

Working with ACC

The Accident Compensation Corporation (ACC) provides comprehensive, no-fault personal injury cover for all New Zealand residents and visitors to New Zealand. This means that if your injury and surgery is accepted by ACC, then the costs of your care and recovery will be covered by ACC, regardless of whether you have health insurance. There are a number of important steps in the ACC process to consider.

When you see Dr. Boyle, the costs of your assessment are completely covered by ACC, as are the costs of any special investigations (MRI scans and CT scans) that Dr. Boyle requests. Once you have decided to proceed with surgery, however, a further request has to be made to ACC to fund your surgery. As part of this request, Dr. Boyle will complete an Assessment Report and Treatment Plan (ARTP) for ACC. For simple injuries, such as an ACL tear in the knee, the ARTP will usually be approved within 2-3 weeks. For more complicated conditions like rotator cuff tears and hip injuries, it may take up to 8 weeks before the ARTP result is confirmed.

It is important to know that although ACC have confirmed that they will cover your initial injury and your specialist review, you will not automatically get your request for surgery approved. Once the ARTP has been processed, you will receive an approval or declination from ACC in the mail. If your surgery is approved, you can simply contact Dr. Boyle's office to schedule your operation.

If ACC declines your application for surgery, we will send you a letter outlining your options. You can lodge an appeal against the ACC decision, use health insurance if you have it, self fund, or be referred to the public health system. Dr. Boyle can help you decide which option is best for you, as ACC will fund one extra clinic visit even if your surgery has been declined.

An ACC appeal takes approximately 3 months to complete. If you have private health insurance and do not wish to wait for the ACC appeal result, it is also possible to proceed with surgery using your insurance and appeal the ACC decision at the same time. Please contact your insurance company in this case, as they will be able to guide you with this process. If you do not have health insurance and wish to appeal the ACC decision, we recommend using an ACC appeals advocate to help you through the process and represent you at the appeal hearing.

Frequently Asked Questions

ACC (the Accident Compensation Corporation) provides no-fault personal injury cover for all New Zealand residents and visitors. If your injury and surgery are accepted by ACC, the costs of your care and recovery are covered, regardless of whether you also have private health insurance.
Yes. A referral from a GP, physiotherapist, or other registered healthcare practitioner is required before ACC will fund your specialist assessment. Ask your healthcare provider to refer you specifically to Dr. Matthew Boyle at Auckland Bone and Joint Surgery. Referrals can be sent via HealthLink EDI: drmboyle.
Yes. The cost of your initial assessment with Dr Boyle is fully covered by ACC, as are any special investigations such as MRI or CT scans that are requested as part of that assessment.
Once you decide to proceed with surgery, Dr Boyle submits an Assessment Report and Treatment Plan (ARTP) to ACC on your behalf. Straightforward injuries, such as an ACL tear, are usually approved within 2 to 3 weeks. More complex conditions, such as rotator cuff tears or hip injuries, can take up to 8 weeks for a decision.
ACC covering your initial assessment does not guarantee your surgery request will be approved. If ACC declines your ARTP, you will receive a letter outlining your options, which may include lodging an appeal, using private health insurance, self-funding, or being referred into the public health system. ACC will fund one additional clinic visit to discuss this with Dr. Boyle even if your surgery has been declined.
Yes. If you have private health insurance and don't want to wait for an ACC appeal outcome, you can proceed with surgery through your insurer and pursue the ACC appeal at the same time. Your insurance company can guide you through that process.
Yes. If your ARTP is declined, you have the right to lodge an appeal. The appeal process generally takes around 3 months to complete.