Please note the following:
- The Health Insurance Act 1973 determines the rules for billing Medicare services. See http://www.comlaw.gov.au/Details/C2012C00842/
- Detailed information on the Medicare Benefits Schedule (MBS) is available at http://www.mbsonline.gov.au
- The person whose provider number is used for billing purposes is legally responsible for those services
- The servicing provider is legally responsible to ensure that patient referrals and requests are medically necessary for the treatment of the patient
- Medicare may undertake compliance audits or reviews from time to time. The electronic claim is considered to be a legal record of the service actually provided.
- If services have been billed incorrectly, the servicing provider is responsible for the repayment of benefits. The Commonwealth are legally obliged to recover such debts.
- Ensure that all items are billed in accordance with MBS requirements
- Ensure you're able to substantiate all claims made under your provider number
- Advise Medicare if you are aware of incorrect Medicare payments, using the Voluntary acknowledgement of incorrect payments form http://www.medicareaustralia.gov.au/provider/pubs/medicare-forms/files/4703-1301en.pdf