Context
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 shared recently as follows:
"I would like to add to this an experience I had some 10+ years ago. I was audited by Medicare that I billed some 50 outpatients a 116 first up without ever having charged a 110. All patients had been admitted to a public hospital as a public patient and I saw them for f/u. I submitted all discharge summaries and after many hours spent to put together all documents, I had a phone call from a Medicare employee that I needed to be "educated", his words, on how to bill. That I was not to ever bill a 116 without having billed a 110. If there is no record with Medicare (and there won't be for public patients) I have technically never seen that patients in their view and therefore cannot bill a 116. I was told by that Medicare officer that I was cleared in that audit but he gave me a significant verbal slap on the wrist. very unpleasant and time consuming experience, particularly as I was trying to do the right thing and save Medicare money.
May be things have changed...one would hope."
