How GPs become the subject of Medicare audit?
There are three reasons to get audited:
- Random audit by Medicare. This happens regardless of your billing practices, the number of items billed and the number of patients seen.
- GP’s billing practices are significantly different from those of his /her peers, GP sees an unusually high number of patients, unusual pattern of billings, seeing 80 or more patients in 20 consecutive days etc.
- Complaint (may be anonymous) from a nurse, another doctor or a patient.