Sandercoe Accounting

Reducing Medicare Audit Risk

The Department of Health views Medicare compliance as a high priority and has increased its auditing process to ensure Medicare is not being misused by patients or providers. Investigations into healthcare professionals misusing the Benefit Scheme rose by 40%, and practitioners were ordered to repay the benefits paid.

No clinic wants their billing processes to be audited, so understanding how to effectively bill, comply and review systems in place is essential.

Know The Rules

Medical billing services have constant changes, making it essential that practices know the rules with regards to billing. In 2017, inappropriate billing resulted in doctors and practitioners facing $29 million in debt – a debt you can avoid if you stay diligent and aware of compliancy rules.

Provide Correct Item Numbers

An easy way to ensure you are being compliant is ensuring you are charging the correct fee for the services provided. Charging for items such as SIP Diabetes, SIP asthma, 36 and HCPs MHCPs ensures your team is billing appropriately and the work is seen by the government as properly remunerated.

This is a system that should be reviewed regularly, as incorrect item numbers can result in an audit. Ensure you are not billing for services that do not have a Medicare benefit, such as cosmetic procedures and tattoo removal.

Ensure Adequate Patient Records

Patient records must contain adequate clinical information explaining the services provided, as well as adequate contemporaneous records enabling another practitioner to easily take over.

Each attendance must have a clearly identifiable, separate entry.

Correct Training

Admin, nursing and clinical staff need to be appropriately trained, as misinformation can be a problem. Medical records need to support billings, correct billing numbers need to be provided, and staff need to be trained on how to effectively do that in compliance with Medicare standards.

Make it easier for your practice to operate with a stable and robust billing and accounting management software.

The right software will make it easy to lodge Medicare and Veterans Affairs claims, credit funds to multiple bank accounts, produce automated alerts for outstanding accounts and provide your clinic with an extensive reporting module.

Streamlining your affairs isn’t solely reliant on billing – you can utilise technology to make prescription management, patient booking and patient data more efficient and reliable too. Choosing to automate bookings and billings will reduce the workload of a practice – so if you have any questions regarding which software to use, Sandercoe Accounting can help you find the ideal software for your practice.

Contact Us Today

If you have any questions about our services and how we can help you, enlist the help of our professional team of accountants today. Sandercoe Accounting’s figures show time again that we are the trusted high-quality accounting team for businesses and medical practices across Sydney and Australia. Using an accounting team with specialities in medical practices could save you thousands of dollars.

Our friendly and knowledgeable team is available online or by calling (02) 9629 9777.



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