How to apply for prior approval for surgery

Before starting the claim, please make sure you have an electronic version of your documents ready, PDFs are preferred but you can also upload these as jpgs, please make sure these are nice and clear images. 

To submit a surgical prior approval request, log into the NZPA website, go to your dashboard and click on the health plan portal tile. This will take you to your health plan portal where you can lodge your claim. On the “Add a new claim” tile click “Start Claim”.  For a surgical prior approval click “Get approval” and follow the steps to lodge your claim details. 

Log into my Health Portal

The process 

If approved, you will then receive a surgical approval letter which includes your approval number, and you take this with you to the hospital. Use the approval number on your hospital admission forms.

Forward any invoices in relation to your surgery to Health Plan, with your member number and approval number as reference.

Paying your cover’s excess

If your cover has a surgical excess, you will be advised by letter on how to pay this once Health Plan has received, and paid, the surgical invoices directly to the provider.

Please do not pay the provider directly until you have been advised by Health Plan on where to pay your surgical excess.

Claiming for appointments pre and post surgery

If you have any costs relating to the surgery, including specialist consultations and scans, these can be claimed in addition to your surgical claim for up to four months following the date of surgery.

To be reimbursed for these, complete a medical claim form via our Health Plan Portal and attach the receipts. Please remember to note your surgical approval number on the claim form.

If you need any help, please contact or call the Member Services Centre on 0800 500 122.