General

Can prisoners really access Medicare funded services while in prison?

14 December 25

I’ve been reading some of your material on social media and wanted to understand how it is possible that prisoners can access Medicare services while they are in prison. For as long as I can r…

If an admitted patient is on day leave and is referred to a adjacent private clinic for a treatment, do we bill them as an inpatient or an outpatient?

7 December 25

We operate a co-located private outpatient clinic on the grounds of a hospital complex. A patient who is an admitted patient in the hospital is referred by the treating doctor to come to our c…

Are the documentation requirements the same if the Department of Veterans Affairs is paying the claim?

3 November 25

If an item number is paid for by DVA does it fall under the same compliance in regards documentation?

…

If I do a telehealth consult on an admitted Bupa ADF patient in another state, can I bill Bupa ADF or charge for it in any way?

21 September 25

I did a telehealth consult on an admitted Bupa ADF patient in another state. The referral came from the Bupa ADF doctor who was with the patient (by his bedside) during my telehealth consult. …

I saw your LinkedIn post that said the MBS is not the law. So what is it?

24 August 25

I was fascinated by your LinkedIn post that said the MBS is not the law. I (and I think the whole nation) always thought it was. How can the MBS and the law be different and what is the MBS th…

How do we know when a patient is admitted? Is there a definition of admission?

18 August 25

At what precise moment in time does a non-admitted patient in the emergency department become admitted? Is it when the admitting doctor makes the decision to admit, or is it after the paperwor…

Do I have to bill a 110 before a 116?

4 August 25

This question has come from two almost identical experiences shared by physicians. The first was reported in my PhD and the second, which appears to have happened around the same time, was sha…

I am a breast physician but am unable to claim the A4 attendance items that physicians claim. They always reject. Why?

7 July 25

I am a breast physician working at a specialised breast clinic but am unable to claim the A4 attendance items that physicians claim – 110, 116, 132 and 133 and the telehealth equivalents. I ha…

Can diagnostic imaging for a public hospital outpatient be bulk billed if there is a named referral and patient consent, but the registrar completes the imaging request form – and is it true that the request does not have to be signed?

29 June 25

Can a request for diagnostic imaging in a public hospital be Medicare billed if:
1) appropriate GP referral to a named obstetrician has occurred
2) the patient has elected to be a no fee pri…

Why are the procedures I bill being rejected when I bill them together with a consultation? I do both so why aren’t both paid?

23 June 25

When I bill an attendance item with a procedure like say, a skin excision, why is the consult paid but the procedure is rejected? It happens a lot, with similar item combinations. I do both th…

If an item says “at consulting rooms” can we bill it if we provide the service not at consulting rooms? What is the definition of a consulting room?

16 June 25

If an item specifies the place (eg: “at consulting rooms”) can we bill it if we provide the service not at consulting rooms? What is the definition of a consulting room? If we provide the serv…

I have been told that inpatient and outpatient care is never linked, except under the aftercare rules. Is that true?

26 May 25

In relation to charging separate fees to patients before their surgery, I’ve heard that inpatient and outpatient claiming is completely separate (except under the aftercare rules) so we can ch…

When (if ever) is it appropriate to bill multiple consultant physician attendances (MBS Items 110 & 116) on the same day?

17 March 25

Can you please weigh in on the following question? I sent this to askMBS and got something of an unhelpful answer.
—
Dear Medicare Support Team,I am writing to seek formal clarification re…

If 92210 is the telehealth equivalent of item 599, does this mean the doctor has to visit the patient, or open the consulting rooms?

10 February 25

If 92210 is the telehealth equivalent of item 599, does this mean the doctor would also have to visit the patient, or open the consulting rooms? I am very confused by this.
I asked AskMBS and…

If we obtain verbal consent from the patient to bulk bill and note it in the patient’s file, is that compliant for bulk billing?

19 January 25

Is a verbal consent noted in the patient’s file enough? If a bulk billed patient has to provide consent by signature for items put through to Medicare this creates additional admin work, in particul…

If a practice nurse does dressings and vaccinations and the GP does not physically see the patient, can the practice nurse bill under the GPs name?

6 January 25

We have a Practice Nurse who does vaccinations and wound dressings etc. Does the doctor have to physically see the patient or can the nurse discuss the patient with the doctor, act on his/her …

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Topics

Specialities

General

Can prisoners really access Medicare funded services while in prison?

If an admitted patient is on day leave and is referred to a adjacent private clinic for a treatment, do we bill them as an inpatient or an outpatient?

Are the documentation requirements the same if the Department of Veterans Affairs is paying the claim?

If I do a telehealth consult on an admitted Bupa ADF patient in another state, can I bill Bupa ADF or charge for it in any way?

I saw your LinkedIn post that said the MBS is not the law. So what is it?

How do we know when a patient is admitted? Is there a definition of admission?

Do I have to bill a 110 before a 116?

I am a breast physician but am unable to claim the A4 attendance items that physicians claim. They always reject. Why?

Can diagnostic imaging for a public hospital outpatient be bulk billed if there is a named referral and patient consent, but the registrar completes the imaging request form – and is it true that the request does not have to be signed?

Why are the procedures I bill being rejected when I bill them together with a consultation? I do both so why aren’t both paid?

If an item says “at consulting rooms” can we bill it if we provide the service not at consulting rooms? What is the definition of a consulting room?

I have been told that inpatient and outpatient care is never linked, except under the aftercare rules. Is that true?

When (if ever) is it appropriate to bill multiple consultant physician attendances (MBS Items 110 & 116) on the same day?

If 92210 is the telehealth equivalent of item 599, does this mean the doctor has to visit the patient, or open the consulting rooms?

If we obtain verbal consent from the patient to bulk bill and note it in the patient’s file, is that compliant for bulk billing?

If a practice nurse does dressings and vaccinations and the GP does not physically see the patient, can the practice nurse bill under the GPs name?

Topics

Specialities

General

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