Medicare audit due to any areas of concern by Medicare.

Most of the audits are in response to suspicion that GP does something wrong. How do they find out?

  • Medicare computer analyses the billing data and alerts the officers.
  • Someone informed Medicare of wrongdoing on a part of GP – usually, another GP and more rarely a nurse. (Little they knew that they would sometimes get audited as well. There is a significant number of complaints by doctors against doctors received by AHPRA and Medicare every month)
  • Inconsistencies in billing practices become apparent in the course of actions by AHPRA and GP gets referred to Medicare.

Practice point: Try not to get offended. There is nothing personal in Medicare auditing you.