General
Do you have to withhold billing item 723 until a formal acceptance to participate is received from at least 2 care team members?
19 September 24At our practice we do not hold the billing, and we charge item 723 on the same day as the GPMP (721). I have heard of other practices who withhold the 723 billing until signed faxes are exchanged wi…
read more >Can a cardiologist self-refer to follow up a patient post discharge from hospital?
24 February 21The question posed was: “Cardiologist, Dr Z, performs a procedure (permanent pacemaker implant) at hospital A (provider number 1), but would like to see the patient for ongoing care/follow up …
read more >If a public inpatient is discharged and then referred back to the hospital outpatient clinic by the GP (so, no previous Medicare billing), can I bill item 132 if I spend more than an hour with the patient?
28 January 21A hospital billing manager asked: If we have a public inpatient that is discharged from the brain injury unit to the outpatient clinic for follow up (at this point no previous Medicare billing…
read more >Can I take over a named referral in a public hospital outpatient setting if I am of the same specialty?
22 January 21Doctor A was a rehabilitation physician working in a public hospital day rehabilitation unit. Prior to patients commencing the day rehab program (where they are admitted inpatients on each day…
read more >Is there any way to charge only the gap and receive the Medicare rebate directly to our account rather than via a cheque sent to the patient?
20 January 21The question asked was: Is there any way to do outpatient billings where the patient pays the gap only on the day, and then the clinic submits a claim for the unpaid Medicare rebate? Currently…
read more >Can we obtain the patient’s signature to consent to bulk billing once, and use it for ongoing care?
20 January 21The question posed was: Can the bulk bill “Assignment of Benefit” be specific to the hospital setting? We understand that patients sign this upon admission, and while it is not specific to any…
read more >Can I bill a private patient in a private hospital who was transferred from a public hospital, and who should the referral be from?
20 January 21Dr A was unsure about correct referral pathways for patients transferred to a private hospital after an episode of care in a public hospital, and how such patients should be billed.
…
read more >How do in-hospital referrals work?
20 January 21A specialist doctor asked how the various specialists below should claim for their services in this very common scenario.
Patient attends the Emergency Department (ED). The ED Dr refers…
read more >Can I rely on answers from askMBS@health.gov.au?
10 January 21Doctor B had received written advice from askMBS which he believed was not only wrong, but likely illegal. He wanted to know if he could rely on the advice.
Detailed Reasoning
The …
Can I bill to Medicare when a patient is in Australia but I am overseas?
8 January 21Doctor A asked what happens when the treating doctor goes overseas for a week of conference leave while the patient is midway through a course of treatment such as chemotherapy or radiotherapy…
read more >Can I bill to Medicare when my patient is overseas but I am in Australia?
8 January 21Doctor A wanted to know whether billing to Medicare was permitted in circumstances where an Australian, Medicare eligible patient, was overseas working or holidaying, and the doctor was in Aus…
read more >In a public hospital outpatient clinic does a referral to “Dear Specialist” enable Medicare bulk billing?
21 September 20Question: If a clinic receives a referral to “Dear specialist” can this be used by anyone in that practice? Or if it comes to a named specialist, can that validly be used by another provid…
read more >Do you get one item 132 and two item 133’s every 12 months?
31 August 20Doctor A worked in a public hospital outpatient department where they exercised a right of private practice. They thought that they were not automatically permitted to bill item 132 every 12 m…
read more >Are inpatient and outpatient episodes considered as separate for billing purposes, so that when a patient is discharged a new episode of care automatically commences?
26 August 20Question: If the same treating rehab physician sees a patient following discharge in their outpatient rooms, can this be billed as an item 132 (obviously with a relevant referral), or is it an…
read more >Can a GP with surgical training bill item 41764?
17 August 20A general practitioner has asked whether they can claim item 41764 given they have appropriate surgical training to perform the procedure, which is a nasendoscopy/sinoscopy.
…
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Medicare Billing Course
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