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How we support quality and resolve issues

A focus on quality helps us understand if the ways we fund services are working. This ensures our clients can make the best recovery possible. We have structures in place to support quality practice and confirm your services meet our policies, procedures, and expectations.

On this page

    How providers receive feedback

    Registered treatment providers are, where possible, sent an annual dashboard. This will include information and trends on the kind and volume of clients you work with, injury types, volume, duration, and claim cost.

    You'll also be able to see how you compare with your peers. This can be helpful for self-reflection, business planning, and clinical discussion with colleagues.

    We may contact you to learn more about you and the services you provide if your data is different to the majority of the providers within the same type.

    How we support accurate invoicing

    We review invoices so we can pick up irregularities before an issue may arise. We'll work with you if unusual patterns or volumes emerge to understand your situation before we process the invoice.

    How we'll work with you

    We have dedicated teams that may contact you to help work through any issues. They're here to understand you and your business, and identify the next steps needed to resolve the issue.

    Dedicated team Why they might contact you
    Engagement and Performance Managers To provide help and support to understand our legislation, policies, and processes. Engagement and Performance Managers manage the relationship between ACC and our contracted suppliers.
    Integrity Advisors To help prevent any potential fraud, waste (carelessness regarding policies or procedures), or abuse (negligence, or failure to exercise proper duties, including the manipulation of policies or procedures).
    Performance Monitoring Advisors To understand any unusual data trends and invoicing.

    If any of the team members contact you, they'll explain why they're contacting you, what their role is, and provide any relevant data or feedback.

    How we manage complaints and allegations

    We'll contact you if we receive a complaint or allegation about you or your service, depending on the nature of the complaint.

    If you have concerns that you believe may need our attention, please contact our Integrity Services team.

    Phone 0508 222 372

    How we manage issues

    We must uphold the quality and quantity of services we purchase. We'll work closely with you to find a resolution to any issue that may arise.  

    Depending on the situation, we may:

    • offer support and education
    • request a review of your clinical records
    • recover any overpayment
    • issue a letter of expectation
    • agree to a performance improvement plan
    • draw on the issue resolution clauses in your contract (for suppliers).

    When we have significant concerns, we may:

    • put in place extra invoicing requirements
    • contact your clients to verify the services provided
    • notify the appropriate regulatory authority or professional body
    • conduct a formal investigation
    • make a referral to the police
    • prosecute.

    If you work for one of our suppliers, usually we'll refer the issue to the company holding the contract for resolution.

    Transparency Statement - Integrity Services

    Working together handbook

    Last published: 10 December 2020