A large multidisciplinary pain clinic engaged us to conduct a comprehensive review of its medical billing compliance across outpatient, inpatient, and compensation scheme services. Scope: We assessed Medicare billing practices, rejection patterns, clinical documentation, referral processes, informed financial consent, and Workers Compensation/CTP claims. The review also included evaluation of the practice management system and internal... The post Pain Clinic – Medical Billing Compliance Re...| Synapse Medical Services | Payment Integrity Expertise and Tech
Our client, a bulk billing general practice serving a complex and vulnerable patient population, sought our help to ensure the long-term sustainability of the clinic. Their goals were to: 1. Understand current billing patterns and identify opportunities for improvement 2. Receive support to implement changes 3. Review billing processes for long-term efficiency We approached the... The post Bulk Billing GP Clinic – Sustainable Billing for a Complex Population appeared first on Synapse Medica...| Synapse Medical Services | Payment Integrity Expertise and Tech
Our client, a leading private provider of fertility services in Australia, approached us for advice on a nuanced Medicare billing issue involving a returning doctor. The clinician in question was an Australian-trained medical graduate who had spent over a decade overseas completing postgraduate training. The question was whether he could begin billing Medicare immediately upon... The post Australian-Trained Doctor Returning from Overseas – Medicare Billing Rights appeared first on Synapse M...| Synapse Medical Services | Payment Integrity Expertise and Tech
An internationally renowned health service provider engaged us to assess the viability of establishing a network of nurse-led urgent care clinics, potentially supported by GPs and Fellows of the Australasian College for Emergency Medicine (FACEM). The vision was to deliver high-quality care for minor injuries and illnesses – particularly after hours and on weekends –... The post Nurse-Led Urgent Care Clinics appeared first on Synapse Medical Services | Payment Integrity Expertise and Tech.| Synapse Medical Services | Payment Integrity Expertise and Tech
A primary care provider delivering services through group appointments approached us for a full compliance review of their Medicare billing. While Medicare generally does not support billing for group consultations, this provider’s model was highly specialised and unlike anything we had seen before. We undertook a detailed legal and billing analysis, reviewing the relevant legislation,... The post Medicare Billing for Group GP Appointments appeared first on Synapse Medical Services | Paymen...| Synapse Medical Services | Payment Integrity Expertise and Tech
A medical specialist engaged us after discovering that fraudulent claims had been submitted in her name – over 1,100 services across a nine-month period. Despite acting quickly and in good faith, she received no support from her medical defence organisation or any other body. Our first priority was to provide peace of mind by helping...| Synapse Medical Services | Payment Integrity Expertise and Tech