The Australian Institute of Medical Administration and Compliance
If I have been providing services to a client under Medicare through a Mental Healthcare Plan (MHCP) and they have been admitted to hospital as an inpatient. Is the client able to continue with their therapeutic intervention sessions via video link from the hospital and claim this under their MHCP?
read more >If my patients book a video telehealth with me online and pay prior to my consultation (given that they have a GP referral in advance) can they get a medicare rebate? Or does the payment need to occur on the same day as the consult for me to charge a 91824 (video consult) or a 91825 (for follow up). My plan is to give my patients an invoice once they pay and they would claim from Medicare. For example, if a patient books and pays for a video consult on Sunday (for a Monday session) but does the actual consult on Monday, can they claim for the consult that occurred on Monday even if the payment was on Sunday? Or do I need to tell them to pay me during or after my actual video consultation. This is very important for me since I would rather take the payment in advance before they actually do the video consultation rather than request payment during my consultation.
read more >This question relates to medical specialists exercising rights of private practice in public hospital outpatient departments. The questioner wanted to know if both Dr ABC and XYZ can use the referral in this context, given they are both named on it. In addition, the questioner had received advice that a “named referral” under the National Health Reform Agreement can only have one name on it, not two. The advice was that the referral had to have “a” name on it, and this was therefore an invalid referral.
read more >A PICC line insertion is performed by a nurse/nurse practitioner and radiographer, including imaging (Fluoroscopy + Digital Subtraction Angiography of thorax). Post examination, a radiologist reviews the images and confirms the positioning and readiness of the PICC line. Noting that the initial catheterisation procedure (13815) cannot be claimed as a nurse performed the procedure, could the radiologist claim for the relevant DSA imaging charge (e.g. 60012)?
read more >Data privacy question. Billing done through billing agents obviously involves the doctor submitting sensitive patient personal details and health information (indirectly by way of item numbers claimed) to the agent to facilitate the claim process. Is patient consent required for this in theory? Do hospital admission templates (signing the form to be a private patient) account for patient consent in this regard? What if the patient withdraws consent? On the other side of this equation, how long do the billing agents keep sensitive patient data (is there a legal requirement?).
read more >This question came from a psychologist but it applies to everyone who can bill to Medicare. No exceptions.
read more >As a radiologist if I’m sitting in an Australian consulate or embassy situated in the United States can I bill Medicare for radiology interpretations?
read more >I have a question regarding the validity of referrals sent via fax without a GP signature. All too frequently the GP gives the client the only signed hard copy and they either lose it or turn up without it. This leaves us chasing a referral. If the receptionist at the GP practice sends us a copy of the referral, they can only do so via fax without a GP signature. Current debate in the professional circles is underway again about whether a referral received via fax without a GP signature is indeed legal under Medicare.
read more >This question came from a consumer. I am an inpatient in a private mental health unit in a private hospital. I am under an inpatient psychiatrist. While I am an inpatient, I have a telehealth review consultation booked with an outpatient psychiatrist who is known to me. I also have a review consultation with an outpatient specialist in person, and a review consultation in an outpatient clinic at a public hospital. I am allowed to leave the private hospital to attend the in-person consults and will then return. But I have heard that these services can’t be bulk billed. I am a pensioner so cannot afford private fees.
read more >In the last 12 months or so, I’ve had repeated problems with referrals marked “indefinite” by the GP. These will be accepted by Medicare for some time, then randomly start getting rejected. Repeated phone calls to Medicare cannot provide an explanation. As a result, I am tempted to reject indefinite referrals – but GPs just see that as a self-serving request assuming I’m just doing it to increase my billings. An issue mostly for patients as they get very disgruntled when Medicare refuses their rebate, and since the event has occurred, they can’t get a new referral from their GP, since it would have to be backdated. An example was given: An inpatient ECLIPSE claim contained both a 116 and a 13918 on the same date of service, with a valid indefinite referral. Claims for this patient had previously been accepted without issue under the same referral. The 116 claim was rejected by Medicare, but the 13918 was paid. This makes me question whether 13918 and 13706 are item numbers that require a referral at all… Nothing in the item wording says they are a referred item number. Can you advise?
read more >
1 Year subscription includes unlimited access to all answers and ability to ask questions.
How does MBS Answers work?
Save $9 by subscribing to the BEGINNER PACK
and get an additional $49 worth of learning.
Pay only $50 more by subscribing to the INTERMEDIATE PACK
and receive up to $248 of additional benefits.
Try the EXPERT PACK for an extra $110 with up to $686 of benefits.
Check out our subscription packages No, Thanks