Claiming funded vaccine
Programme start date for eligible patients and healthcare workers is 18 March 2020
The 2020 Influenza Immunisation Programme started on 18 March 2020 for individuals who are eligible to receive a funded influenza vaccination, as they are at greatest risk of serious illness from influenza, and healthcare workers (not funded).
- Funded influenza vaccine can be administered to eligible individuals aged 3 years or older and claimed from 18 March 2020.
- Influenza vaccine for children aged 6–35 months will be available from 1 April 2020.
- Pharmacist vaccinators with a contract to administer funded influenza vaccines can administer and claim for influenza vaccination of eligible individuals aged 13 years and over from 18 March 2020.
- The Ministry of Health asks that general practices, pharmacies and occupational health providers defer administration of purchased (non-funded) influenza vaccines until mid-April, to allow eligible individuals and healthcare workers to have priority access to influenza vaccination.
The patient’s correct NHI number is essential to process the claim - an incorrect NHI number (often adding the letter ‘o’ rather than a zero ‘0’) is the most common reason for rejected claims.
If you do not know your patient’s NHI number, phone Sector Services on 0800 855 151. You will need:
- Your payee number
- Patient’s surname, first name and middle name
- Patient’s gender and date of birth
- Patient’s previous address
- Any other name/s the patient has been known as
Available via most Practice Management Systems.
Download the form at:
Please note manual claims require District Health Board written approval. The written approval must accompany manual claims when sent to Sector Services.
Please select correct coding box.
Funded vaccines eligible for payment need to be submitted within eight months from the date the patient received the influenza vaccine. Funded vaccines eligible for payment must be administered within the subsidised period.
Note: The second influenza vaccine dose for eligible children aged under 9 years must have been given within one month after the end of the subsidised period to be able to be claimed and only when prior approval has been given by your DHB.
General practices: Claiming for ZOSTAVAX® and INFLUVAC® TETRA or AFLURIA QUAD®
The Ministry of Health advised that PMS systems have been updated as of 18 March to enable dual claiming of zoster vaccine at the same time as influenza vaccines – claims for zoster and influenza vaccines administered before then can be manually claimed for.
Pharmacies: Claiming for funded influenza vaccination for 13–64 years
Pharmacists should claim for administration of all funded influenza vaccinations to individuals aged 13–64 years through their pharmacy system as they currently do for other funded influenza vaccinations. The Ministry is currently investigating the feasibility of amending ImmuniseNow to support the new funded criteria, and will communicate the findings to the sector once the investigation is complete.
For claim enquiries, please contact Pharmacy Claim enquiries on 0800 353 2425 and select option 1.