I read an article in The Conversation linking known-gap billing to the schedule fee. Now I’m confused. I thought known-gap billing allowed us to charge up to $500 and also submit a no-gap clai…
read more >We are a new private hospital and want to get our Minor ID connected to start billing. Is connecting the Minor ID to Medicare for medical billing the same process as connecting the Facility ID…
read more >We do not have contracts with the private insurers but we are a Tier 2 facility. We understand that they have to pay us the default benefits but what is the timeframe for these payments?
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read more >I admit privately insured chronic pain patients for overnight ketamine infusions. There is no specific Medicare item for the infusion itself. Can I charge the patient a private fee (e.g. $1,40…
read more >I keep hearing the term ‘Tier 2’ used in different contexts. Is a Tier 2 private hospital the same thing as Tier 2 funding for public hospital outpatients?
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read more >When does the “Time in Theatre” start and end for the purposes of billing a Same Day Band 3 or 4.
We have multiple facilities billing a Same Day Band 4, however the “Patient on Table” and “Patient …
Can medical specialists charge patients a separate administration/facility/booking fee before they are admitted to hospital for their procedure in the context where claims will be submitted to…
read more >We are seeking clarification regarding MBS item no. 00599 (after-hours item) and its applicability in certain settings. Specifically, we would appreciate your guidance on the following points:…
read more >Is the following correct? For item 13706, I was informed by askMBS that two items are generally paid in one day, as long as they are clearly indicated to be separate transfusion episodes -…
read more >I work in a public hospital and suddenly all of my outpatient procedures that I bulk bill are being rejected. They have been paid without issue for years. What’s going on?
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