How to minimise risk of being audited? (cont.)

  • GP consistently provides services to close to 80 patients a day or more – highly likely to get audited.
  • The sum of the time for the items billed in one day is beyond the reasonable working day. E.g. the sum of the time for items billed is more than 12 – 14 hours in one given day. Item 36 counts as 20 min, 44 as 40 min, 23 as 10 min, Care Plan as 20 min, Mental Health Plan 2717 as 40 min, Health assessment 703 as 30 min etc. Someone at Medicare will add up all of these times together. If the sum of the items amounts for some unreasonably long day in many consequent days, there might be some problems. Defence for this will be difficult but possible if you were assisted by a nurse in services that allow such assistance e.g. assessments and Care Plans.


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