Referrals

Can Medicare be charged by a pathology company if the request was signed by a doctor who did not see the patient and is not going to view or interpret the results?

26 January 26

Can Medicare be charged by a pathology provider if the pathology request came from a doctor who has no intention of viewing the results. An online vendor issues the request and charges a fee f…

Are GPs legally required to name referrals for patients they send to public hospital outpatient departments?

23 January 26

We have been told that we must make GPs put a name (of a specialist) on their referrals so that we can bill Medicare for patients we see as public outpatients. Some GPs refuse to do this. What…

When can you bill a new patient item (e.g.110) when a patient is privately admitted to a public hospital but is already known in some way in outpatients to your clinical team?

28 September 25

When can you bill a new patient item (e.g. 110) when a patient is privately admitted to a public hospital but is already known in some way in outpatients to your clinical team?
E.g. When a pa…

Do referrals to public hospital outpatient clinics have to be written exclusively by GPs or specialists exercising a ROPP?

18 August 25

The CFO of our public hospital gave a talk on Medicare billing recently and told us that any referral written by anyone other than a GP or specialist exercising a ROPP cannot be used to bill M…

If a specialist moves to a new practice, do the patients following this specialist need a new referral?

21 July 25

If a specialist leaves one practice and joins another new practice, do the patients following this specialist from the old to the new practice need a new referral? It will be very difficult to…

Is the name of the patient’s GP required on an in-hospital referral?

24 March 25

On an internal referral written by a Specialist/ Physician does the patients GP details have to be written as per the Health Insurance Regs Section 99. As it is an internal referral the patien…

If Doctor A writes a named referral to Doctor B from Doctor A’s private rooms to a public hospital outpatient clinic and through the triage process Doctor A is assigned the patient to treat in the public hospital outpatient clinic can MBS be claimed?

3 March 25

If Doctor A writes a named referral to Doctor B from Doctor A’s private rooms to a public hospital outpatient clinic and through the triage process Doctor A is assigned the patient to treat in…

Can a specialist use the same referral in different locations?

8 December 24

If you work in multiple outpatient locations, and first see the patient in Location A for an initial consult and bill a 110, can you provide a follow up consult from Location B (which has a di…

If a referral is addressed to “Dr ABC or Dr XYZ” can both doctors use it when exercising a ROPP?

17 November 24

This question relates to medical specialists exercising rights of private practice in public hospital outpatient departments. The questioner wanted to know if both Dr ABC and XYZ can use the r…

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 w…

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. Re…

When an obstetrician takes over the care of another obstetrician’s patients while they are on leave and intends to undertake the births is that shared care?

5 October 24

Obstetrician A is going overseas. Obstetrician A’s patients due for delivery while she is away will be looked after by Obstetrician B for antenatal visits billing 16500. Obstetrician B usually…

Do specialists need a valid referral to claim referred services for every private patient they bill?

30 September 24

I am a rehabilitation specialist working in a private hospital doing Day Rehab (patients are inpatients as they are admitted for the day). Usually, I see patients on the day they attend therap…

Should I bill an initial consultation or a follow-up the first time I see a patient in day rehab whose admission was under one of my rehab colleagues?

30 September 24

I am working in a day rehabilitation setting at a private hospital (patients are admitted for the day for allied health interventions mostly after joint replacements and are inpatients when I …

Do I need a specific referral to admit the patient privately for every episode requiring admission?

27 September 24

No additional context was provided.

…

If a patient presents at a public hospital outpatient clinic with a named referral from their GP and needs admission but wants to go to a private hospital, is a new referral required?

27 September 24

If I see patients referred to me in the public clinic, and they are unwell and require admission to hospital at presentation to the clinic as patients with chronic disease sometimes are, do I …

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Topics

Specialities

Referrals

Can Medicare be charged by a pathology company if the request was signed by a doctor who did not see the patient and is not going to view or interpret the results?

Are GPs legally required to name referrals for patients they send to public hospital outpatient departments?

When can you bill a new patient item (e.g.110) when a patient is privately admitted to a public hospital but is already known in some way in outpatients to your clinical team?

Do referrals to public hospital outpatient clinics have to be written exclusively by GPs or specialists exercising a ROPP?

If a specialist moves to a new practice, do the patients following this specialist need a new referral?

Is the name of the patient’s GP required on an in-hospital referral?

If Doctor A writes a named referral to Doctor B from Doctor A’s private rooms to a public hospital outpatient clinic and through the triage process Doctor A is assigned the patient to treat in the public hospital outpatient clinic can MBS be claimed?

Can a specialist use the same referral in different locations?

If a referral is addressed to “Dr ABC or Dr XYZ” can both doctors use it when exercising a ROPP?

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

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

When an obstetrician takes over the care of another obstetrician’s patients while they are on leave and intends to undertake the births is that shared care?

Do specialists need a valid referral to claim referred services for every private patient they bill?

Should I bill an initial consultation or a follow-up the first time I see a patient in day rehab whose admission was under one of my rehab colleagues?

Do I need a specific referral to admit the patient privately for every episode requiring admission?

If a patient presents at a public hospital outpatient clinic with a named referral from their GP and needs admission but wants to go to a private hospital, is a new referral required?

Topics

Specialities

Referrals

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