Urgent after-hours attendance items

Urgent after-hours attendance items

The Department of Health and Aged Care (DHAC) is conducting an early intervention compliance activity (‘targeted compliance’) focused on MBS urgent after-hours attendance items 585, 588, 591, 599 and 600.

This activity includes a checklist provided by DHAC which explains the following criteria (emphasis added):

The MBS urgent after-hours items may be used when the medical practitioner determines, from the information available, that the patient’s medical condition requires urgent assessment during the unbroken after-hours period. Specifically, the practitioner must form an opinion that the assessment cannot be delayed until the start of the next in-hours period.

• The attendance must be requested by the patient or a responsible person.
• The request must occur during the same unbroken urgent after-hours period in which the medical service is provided.
• Prior to the consultation, the practitioner has formed an opinion that the patient's medical condition requires urgent assessment during the unbroken after-hours period, and cannot be delayed until the start of the next in-hours period.
• You attend the patient at the patient's location or reopen the practice rooms for the attendance.
• A record of the assessment has been included in the patient’s medical record.

For more information on MBS after-hours attendance items, see tinyurl.com/MBS-Note-AN019.

Medicare compliance video

On 5 September 2023, we launched a new video resource for MDA National Members on Medicare compliance – The practicalities of Medicare – accessible to Members via Member Online Services.

This video has been produced by the MDA National Medicare Committee (Nerissa Ferrie, Nicole Golding, Dr Elizabeth Harris, Gae Nuttall and Daniel Spencer) and addresses some of the most commonly asked questions around Medicare compliance.

In the video, we take you through:

• chronic disease management
• the audit process
• the rules around bulk billing
• the principles that guide co-claiming of MBS items
• telehealth, including the 30/20 rule
• what can’t be billed to Medicare
• monitoring what is billed to your provider number.

We’re not Medicare, and we can’t provide a formal legal interpretation of the MBS, but we can share the knowledge we gain through roundtable meetings with the regulators and key stakeholders, and the feedback other Members receive when they are the subject of a Medicare audit.

Many compliance audits relate to GP items – particularly chronic disease management – but co-claiming and the audit process applies to all medical specialties.

We urge everyone to watch the video, and please remember to contact MDA National if you receive any audit correspondence from DHAC, the Practitioner Review Program, or Professional Services Review.

DHAC's Online Compliance Program

If you receive a call from DHAC about an OCP audit, it’s not an audit of your oral contraceptive prescribing!

The OCP is a new, user-friendly, online audit platform which is being trialled by DHAC in a recent targeted compliance exercise relating to the billing of MBS items 31206 and 31356 to 31376 (inclusive).

We’ve seen the new platform in action and can help you conduct your self-audit. So please contact us on 1800 011 255 or advice@mdanational.com.au, if you receive notice of this audit.

 

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