Speak Out October 2018

in practice

Billing under Medicare?

IF YOU ARE BILLING UNDER MEDICARE IT IS IMPORTANT TO FAMILIARISE YOURSELF WITH THE KEY CHANGES TO MEDICARE COMPLIANCE.

THESE CHANGES ARE a result of recent updates to legislation under several sections of the Health Insurance Act (1973), the Dental Benefit Act, 2008 and the National Health Act, 1953 and are summarised below. More information about Health Professional Compliance is available on the Department of Health website. Record keeping: New records must be kept for a minimum of two years. This includes referral forms and documents created when claiming an MBS item, for example, invoices. If there are concerns that an amount of money has been paid to you that is more than you should have been paid then the Department can require you to produce documents to substantiate amounts claimed. SPA is aware that many members already maintain excellent records, but this new legislation is a good reminder of a provider’s responsibilities when billing under Medicare. Debt recovery You are legally responsible to repay any incorrect payments made to you even if it is the result of an accidental claim or payment. If you owe money to the Department as a result of incorrect billing, you will receive an invoice with the amount to be repaid. You must pay this within 28 days. If

you do not pay this the Department can now recover the debt through a variety of means. For example, they could reach an agreement with you about how the debt will be repaid or put in place "offset arrangements" where the Department can deduct the debt future amounts owed to you. If a repayment plan has not been agreed upon within 90 days, the Department can issue a Garnishee Notice that allows them to recover the debt directly from your bank account. If you owe more than $2500 to the Department, financial administrative penalties can be applied (approximately 20% of total debt). As of 1 July 2019, the Shared Debt Recovery Scheme will allow the department to hold an employing organisation responsible for a portion of debts incurred as a result of incorrect Medicare claiming. To assist with this process, the Provider Number Application form has been changed in order to collect information about your employer. More information about applying for a provider number and compliance under Medicare is available on the Rebates and Funded Programs section of the SPA website.

Nichola Harris Senior Advisor Professional Practice

private practice seminar Save the date:

Melbourne: Friday 1 February 2019 Newcastle: Friday 1 March 2019

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October 2018 www.speechpathologyaustralia.org.au

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