Margaret Faux, Author at AIMAC

Can a radiologist sitting in an Australian consulate or embassy overseas bill Medicare for radiology interpretations in Australia?

4 November 24

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?

If an allied health provider receives a faxed referral from a GP that is not signed, is it a valid referral?

4 November 24

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.

Can an inpatient of a private psychiatric hospital attend bulk billed outpatient appointments whether by telehealth or face-to-face?

28 October 24

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.

Why are my claims with indefinite referrals from the GP being rejected by Medicare?

24 October 24

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?