Tech hiccups, the items missing out on a boost and where to find an extra 20 cents (don’t spend it all at once).
It’s the day of the biggest funding boost to bulk billing in the history of Medicare and the dawn of a new era for the scheme, as the first benefits of patient enrolment go live.
The government has had since May to prepare for this and make sure all the details are ironed out, so The Medical Republic is pleased to report that it all went off without a hitch … right? Right?
Of course not.
There’s a not-insignificant wrinkle for GPs who want to bulk bill patients registered with MyMedicare for the new long telehealth consults and receive the bulk billing incentive.
The government hasn’t given GP practice software vendors the ability to connect through a Services Australia system to retrieve a patient’s MyMedicare registration status, meaning GPs will have to manually check on a separate system to see whether a patient is enrolled with the practice prior to billing.
The only place this will have an effect, for the time being, is on level C and D phone consults and level C, D and E video consults, the rebates for which are only available to patients who enrol with a practice.
Because practice software will have no visibility on whether a patient is enrolled – and is therefore eligible to be bulk billed for a long telehealth consult – GPs will have to separately add the tripled bulk billing incentive to MBS claims for these appointments.
Software vendor Best Practice says it will be rolling out an update within the next two months that would allow doctors to record a patient’s enrolment status in their record.
“We had no visibility of what the specific incentive item numbers were going to be, nor which items were going to rely on the patient’s MyMedicare registration status, until two weeks ago,” Best Practice head of commercial and government Jessica White told TMR.
“As most [practice management system] products manage the incentives automatically being applied to a patient account based on the relevant MBS criteria, this information was critical and has now resulted in practices having to manually manage a billing process for a subset of item numbers.”
Because the practice software still won’t be able to see into the Services Australia database of patient enrolments, doctors will still have to do this process manually for each individual patient.
Still, the change is expected to make the billing process run smoother.
Services Australia is reportedly in talks with vendors via the Medical Software Industry Association to work on a more permanent solution.
“Unfortunately, we are in the early stages of this project and have no time frames from Services Australia around when we might have access to integrate with the MyMedicare system to pull through a patient’s MyMedicare registration status,” Ms White said.
TMR reached out to MedicalDirector, the other major software vendor, for comment but didn’t hear back before deadline.
The new, tripled bulk billing incentive amount will automatically apply to all four of the eligible time-based face-to-face consults (regular and after hours), from levels B through to the yet-to-be-established level E, as well as level B telehealth general attendance consults.
Other GP non-referred attendances – specifically the items covering antenatal care, mental health and chronic disease – will still be eligible for the bulk billing incentive, but only the regular, non-tripled amount.
MyMedicare opens today. Here’s the impact on the Medicare rebate. Medicare is like car insurance. You pay the mechanic, the insurance company gives you some money back. When we bulk bill, we accept the money Medicare gives you as full payment. Here’s why I can’t BB Mental health. pic.twitter.com/qK7sccAdtm
— Louise stone (@GPswampwarrior) October 31, 2023
Level B consults are also undergoing a slight facelift – from today, there is a six-minute minimum consult length for items 23, 24, 5020, 5023, 5028, 90035 and 91800, where it’s time limit was previously defined simply as lasting less than 20 minutes.
November 1 also marks the introduction of the second round of Medicare indexation this year.
Everything has gone up by 0.5%, meaning a standard GP consultation rebate will rise from $41.20 to $41.40.
This extra 20 cents will get you almost one-third of the way toward affording a singular lollipop.
General practices and Aboriginal Community Controlled Health Services can also begin obtaining consent from patients for lifetime registrations from today, as part of ongoing changes to the Practice Incentive Program – Indigenous Health Incentive.
