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46
Margaret Faux is
Managing Director
of Synapse Medical
Services.
The answer was touched on by a reader in
a welcome reply to my article Claiming on
Consumables
, which appeared in the last
issue of this magazine. The reader offered an
alternative solution, involving adding fees
for consumables such as bandages, which
was fully compliant with the law.
The reader suggested that you bill the
patient for the service, say item 23, at the
Medicare rebatable price, let's say $30,
and then add the consumables like bandages,
say $10, on top. In that way the patient
would not ultimately be out of pocket
for the service but they would pay for
the consumables.
At the point of service the patient would
have to pay the full amount for both
consultation and consumable but would
get the consultation fee straight back ­
the patient pays $40, gets $30 back almost
immediately from Medicare and the law
is obeyed. It's nice and neat and, best of
all, the practice gets reimbursed for the
consumable items.
The structure of this hypothetical claim
is applicable to all medical practitioners in
private practice and is underpinned by the
legal nature of the relationship between
doctors and patients under our national
health scheme.
The example was both helpful and legally
correct, and therefore useful to us all.
Contracts, claiming
and the colon
Putting the sometimes perplexing Medicare rebate in the spotlight,
Margaret Faux explores bulk billing versus patient claims.
Please take this quick quiz...
Q:
I have a contractual relationship with my patient as a service provider:
a. When I bulk bill
b. When I don't bulk bill
c. Whether I bulk bill or not
d. Don't be silly ­ I'm a doctor, not a service provider!