> -----Original Message----- > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] On Behalf Of Duncan Guy > Sent: Friday, 23 February 2007 3:58 PM > > IF the patient is bulk billed, and there is indeed no > referral then the specialist is defrauding.
If there is no referral, the use of referred rate Medicare item numbers by the specialist is fraud (committed by the specialist) whether the service is bulk billed or not. > > IF the patient is billed, pays the account, then goes to > claim back is the specialist an accomplice (if they enter a > false referral). Not just an accomplice, but in fact the main perpetrator. It is the specialist who is deciding to use referred rate item numbers when he or she knows that the patient has not been referred. I doubt that the patient would be held to have any responsibility at all. All that the patient knows is that he or she was given an account for $X, paid the $X and went to Medicare to claim whatever Medicare benefit he or she was entitled to. Putting the correct item numbers on the account is *entirely* the specialist's responsibility. > > I could save Medicare many millions of dollars very quickly > by shutting down a few enterprises offering "free" services > here in Sydney, it would save them running around quibbling > over "scanned" referrals. Please do it. Oliver Frank, general practitioner 255 North East Road, Hampstead Gardens South Australia 5086 Ph. 08 8261 1355 Fax 08 8266 5149 M 0407 181 683 _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
