Are the AMA fees really “recommended”?
19 January 26It is very common that doctors describe AMA fees as being “recommended fee”, but I wanted to check whether that was correct. I have recently heard it may not be.
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Private Health Insurance
Are inpatient telepsychiatry items able to be billed to health funds using no-gap schemes?
7 December 25There are relatively new inpatient telehealth items for psychiatrists. We are not sure if we should bill them only to Medicare or if they are covered under the private health insurer’s gapcove…
read more >Can hospital administrators type change a patient from a valid private election back to being public without the patient’s consent?
3 February 25What happens to billing of a private patient in a public hospital who undergoes solid organ (other than kidney) transplantation? There is no MBS item billable for this so it can’t be billed to…
read more >How do I correctly administer a known-gap claim without breaking the law that applies to illegal split bills?
8 December 24I’m working as a surgical assistant. I sometimes charge the patient a gap. My registration with each fund is ‘known gap’. As an example – Bupa pays $386 for assisting a 49518. I want to …
read more >Can an inpatient of a private psychiatric hospital attend bulk billed outpatient appointments whether by telehealth or face-to-face?
28 October 24This 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…
Why are outpatient item numbers that attract 85% of the Medicare Schedule Fee not listed by the private health insurers?
3 October 24The question was posed in the context of public hospital outpatient services where clinicians can bulk bill when exercising a Right of Private Practice providing all other criteria are met. Th…
read more >Medicare Billing Course
Medicare Billing Course
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