Where to find help? Indemnity insurance, consultants. What to expect? There are various professionals that help with audits. However, none of them can be the only resource for getting through the audit. Advice by your indemnity insurance provider is useful. They engage lawyers to act in your interests. However, the Read more…
You have reached an agreement with Medicare. What is next? How to reduce the impact of the ‘penalty’. Your accountant will assist you in recalculating the relevant tax returns. Repayments to Medicare are, essentially, refunds to customers and considered an expense. Ask for repayments to be arranged by instalments. BACK Read more…
Medicare proposed the ‘punishment’. It is not the end of the game. Your options. You CAN negotiate with Medicare stating financial commitments, carer’s commitments, charity work etc. You will need statements and statutory declaration to justify that. BACK NEXT
Things got worse – you are in front of PSR (Professional Services Review). What to do and what not to do. Most important is not to progress to a full Panel Review. In other words, agree and negotiate with the Director of Professional Services Review. Do not let the situation Read more…
First response did not work. What is next? You are invited to attend an interview with the Medicare official. Do not argue. Be as calm as possible. Try to negotiate 6 months review and promise that in 6 months you will address all of the Medicare concerns. It works (sometimes). Read more…
First response is the most important in dealing with the audit. How to produce the first response. Must not be too formal. Must not be too long. Must include Introduction, itemised Body and a Conclusion. Introduction: 2-3 small paragraphs telling about yourself, your guiding principles in medicine. Body. addressing all Read more…
You have received the letter of audit. What to do? Do not panic. Most audits result in no action other than caution. Do not pick up the phone and call Medicare demanding answers to the question: “Why me? Withdraw your audit, please, I am innocent”. Do not write any replies Read more…
Home visits – wrong pattern. Home visits are regular at the same address for multiple patients. “Corridor runs” Only one or two types of items are billed for all home visits work. That does not make sense. All attendances cannot be urgent or all attendances can be not urgent. E.g. Read more…
Care Plans and Mental Health Plans – wrong pattern. I am not aware of any particular internal guidelines at Medicare on the pattern of services. I could only notice that GPs with certain patterns are more often audited than others. It is common sense that if GP is interested in Read more…
Care Plans, Assessments, Mental Health Plans – how many is too many? There are no guidelines exist in regards to how many Chronic Disease items GP should bill. Various sources of statistics state that 20 – 30% of Australians suffer from chronic conditions. We can also see from the attendance Read more…