Neonatal Private Transfer Policy 2006-07
Transfer of approved public neonatal patients to private hospitals
Introduction
To assist during peak periods where the demand for neonatal services outstrips the capacity of the public hospital system, the Department of Human Services provides funding for public patient care in private hospital nurseries. The funding is for approved public neonatal patients being transferred from public to private hospitals.
This policy outlines principles and procedures for such transfers and will be reviewed in partnership with public health services and the Newborn Emergency Transport Service (NETS) at the completion of the 2006-07 financial year.
Principles
Funding for neonatal transfers to private hospitals is made available on the understanding that:
- the neonatal system is under extreme pressure and every attempt has been made to locate a clinically and geographically appropriate bed in a public hospital. This must be documented by the referring public health service
- appropriate care is available in the private sector, that is, the private hospital has the staff, equipment and facilities to provide care for the baby and the family
- the neonatal private transfer principles and procedures are met.
Procedures
- Proposed neonatal transfers to private hospitals must be approved by the NETS Director or delegate prior to transfer. This will ensure maximum use of public neonatal beds and facilitate monitoring of the transfer arrangements.
- Authorisation from the Department of Human Services is required to extend the length of stay in a private hospital special care nursery beyond seven days. If authorisation is not sought within seven days or if it cannot be satisfactorily demonstrated that a bed was not available in the public hospital system, the referring public health service will be liable to pay the additional cost of care in the private hospital.
- Prior to transfer of the baby to the private hospital nursery, an expected discharge date is to be agreed between the referring health service and the private hospital.
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Health services are required to:
- liaise with NETS and ensure every step has been taken to maximise use of public neonatal beds
- maintain contact with the private hospital to monitor the baby’s progress and to arrange for a return to a public hospital nursery or for the baby’s discharge as soon as is clinically appropriate. Any change to the anticipated discharge date should be discussed with the referring clinician
- develop protocols with the private hospitals in their local area for transfer of approved babies. Protocols are to include informing parents that their baby may be transferred back to the public hospital system when a public bed becomes available (either in a Level 3 or a Level 2 hospital), monitoring the baby’s progress and liaising with the private and public Level 2 hospitals to facilitate transfer to the public hospital system when clinically appropriate and a suitable bed becomes available
- provide information to parents about protocols for private transfers.
NETS is required to:
- ensure appropriate steps have been taken to maximise use of public neonatal beds prior to approval for private transfers
- monitor transfer arrangements
- develop an advanced protocol arrangement with private hospitals to facilitate cost-effective private hospital options where possible
- advise private hospitals of billing procedures for payment of private transfers following approval of transfer
- provide payment to private hospitals for all costs associated with the episode of care in a timely manner
- maintain details on the private transfers. This includes authorisation and transfer dates and circumstances for the transfer, including public neonatal system capacity at the
time of request.
Billing procedure for private hospitals
Private hospitals should forward an invoice for all costs associated with the episode of care to NETS. The invoice should include medical, pathology and radiology costs.
Invoices are to be made out to:
Attention: Director
Newborn Emergency Transport Service
132 Grattan Street
Carlton 3053
The invoice should include admission and discharge dates as well as an itemised account.
Recording neonatal transfers on the Victorian Admitted Episodes Dataset (VAED)
As detailed in Hospital Circular 15/2000, all transfers of neonates to private hospitals should be recorded on the VAED as ‘contract care’. To do this, coding or nursing staff should enter data in the following fields:
This field indicates the funding arrangement for the episode of care. Coding/nursing staff should enter ‘1’ in this field, meaning the patient is receiving contracted hospital care under an agreement between a purchaser and a provider of an admitted or non-admitted service.
This field describes the arrangements between the contractor and contracted service provider. It is mandatory if the funding arrangement is ‘1’ (contract). Coding/ nursing staff should enter ‘1’ of options 2 to 5. Funding arrangements 1, 6 and 7 apply in this situation.
- Complete other relevant fields in accordance with the section on recording of ‘contract care’ in Section 4 of the VAED manual.
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