If you have any questions about the process or guidelines, please email [email protected] or write to Southern Cross Health Society, Private Bag 99934, Newmarket, Auckland 1149.
Value-based healthcare is defined as outcomes that matter to our members relative to the cost of delivering those outcomes. We live in an age of innovation in healthcare where many advances in medical technology have significantly improved outcomes. However, some technologies add substantial cost without adding significant outcomes benefit (eg decreases the value of treatment).
As a not-for-profit, Friendly Society, it's important we have a clear process to approve coverage for new technologies that allows us to prioritise value. We have developed guidelines so that there is a clear and consistent process for our value-based approach to funding healthcare delivery.
Once an application is received, the procedure / technology will be placed on the Southern Cross Health Society unapproved healthcare services list until assessment is completed.
You will be advised of the outcome of your application within four to seven months from the date of a complete application being received. Your partnership manager and the health technology team will keep you informed of the status of your application as it moves through the process.
Your partnership manager will advise you directly about our decision. Once an application is received, the procedure / technology will be placed on the Southern Cross Health Society Unapproved healthcare services list. Services that are declined cover will remain on the list of Unapproved healthcare services which is published on the Southern Cross website.
It will remain on our list of Unapproved healthcare services until the service is added to our health insurance policies as part of a policy update. After that, it will be removed from our list of Unapproved healthcare services. If you have an eligible patient for a newly approved healthcare technology, please contact your partnership manager.
Southern Cross Medical Care Society (trading as Southern Cross Health Society) is a licensed insurer and a licensed financial advice provider. For more information about the financial advice service we provide and a copy of our public disclosure statement please visit southerncross.co.nz/disclosure-statement.
Southern Cross Medical Care Society (trading as Southern Cross Health Society) has an A+ (Strong) financial strength rating given by Standard & Poor’s (Australia) Pty Limited. The rating scale is: AAA (Extremely Strong), AA (Very Strong), A (Strong), BBB (Good), BB (Marginal), B (Weak), CCC (Very Weak), CC (Extremely Weak), SD or D (Selective Default or Default). Ratings from ‘AA’ to ‘CCC’ may be modified by the addition of a plus (+) or minus (-) sign to show relative standing within the major rating categories. Full details of the rating scale are available at www.spglobal.com/ratings/en/about/intro-to-credit-ratings. Standard & Poor’s is an approved rating agency under the Insurance (Prudential Supervision) Act 2010.
