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.