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Medicare Billing Compliance

Description

This introductory module provides medical professionals with information on:

  • the role of compliance in the Medicare system
  • relevant regulations and legislation
  • obligations with regards to claiming under Medicare
  • processes and procedures should an incorrect claim be identified.
It is provided as a general reference on the understanding that the Department of Health is not providing endorsed material or professional advice.

Completing this module does not exempt a medical professional from Medicare billing compliance responsibilities and does not confer any privilege or exemption in the event of a breach of the Health Insurance Act 1973 or any other related legislation.

About the education provider
The Department of Health has a diverse set of responsibilities, but throughout there is a common purpose, which is reflected in their Vision statement: ‘Better health and wellbeing for all Australians, now and for future generations.

The Department of Health aims to achieve their Vision through strengthening evidence-based policy advice, improving program management, research, regulation and partnerships with other government agencies, consumers and stakeholders.

Type
3 hours Online Learning

Accreditation
ACRRM 3 PDP
RACGP 6 QI&CPD points

Learning Outcomes

  1. Implement Medicare compliance regulations and procedures
  2. Conduct accurate Medicare billing for patient consultations
  3. Manage appropriate Medicare record keeping
  4. List and explain provider obligations to substantiate Medicare claims
  5. Complete a Voluntary Acknowledgement form if an incorrect claim is made
Topics
  • Module Overview
  • Introducing Medicare Billing
  • Understanding Compliance Regulations and Procedures
  • Billing and Record Keeping
  • Substantiating Claims
  • Voluntary Acknowledgement
  • Providing Feedback and Raising Concerns

Focus
Medicare Billing, regulations, standards, procedures, government, rebate, compliance, billing, Medicare, PBS, MBS, PRP, voluntary acknowledgement form, Health Insurance Act 1973, record keeping, substantiating claims, provider number, health programs, incorrect billing, incorrect payment, audit

Medical Audience
GP, GP Registrar, Specialist, Doctors in Training/DIT, Junior Doctor, Medical Student, International Medical Graduate, Overseas Trained Doctor

Department of Health
621057
Online Learning
3h : 0m
MBA: 3h : 0m
RACGP: 6 pts
ACRRM - Fellow: 3 pts
ACRRM - Non Fellow: 3 pts
Administration and health services

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Modules in the Learning Course

  • Medicare Billing Compliance Module overview
    Online Learning

    Module overview

  • Introducing Medicare Billing
    Online Learning

    Topic 1

  • Understanding Compliance Regulations and Procedures
    Online Learning

    Topic 2

  • Billing and Record Keeping
    Online Learning

    Topic 3

  • Substantiating Claims
    Online Learning

    Topic 4

  • Voluntary Acknowledgement
    Online Learning

    Topic 5

  • Providing Feedback and Raising Concerns
    Online Learning

    Topic 6

  • Feedback Survey
    Survey

    Medicare Billing Compliance