Thread: Your Doctor - an opinion I think worth considering

There seems to be a bit of a fuss being made in some sections of the media about doctors "rorting" medicare at the moment. I am sure that if the medicare rebate actually came close to the cost of servicing patients the temptation to do this would be less. A question maybe for Navy Diver - how corporatised is the GP industry in general? It certainly isn't in Yass with most of the practices falling inn the realm of "small business", however I can see that corporate entities might be tempted to develop ever bigger groups of practices for which the temptation to deliver profits is more important than delivering services. This happen somewhat disastrously in the childcare industry with many big players going broke once the big corporates were forced to become more accountable.

I have witnessed some overservicing at my local practice with pathology reports requested in circumstances where they may be excessive and a solid push to move six monthly appointments to three monthly when there is not a good medical justification, but it is fairly low level. The medical industry does have a very influential lobby group in the AMA and any reform is difficult in the face of claims that "everyone will have to pay to see the doctor" that are raised every time the AMA is displeased.

Medicare fraud: Bulk-billing rates inflated through rorts

Regards,
Tote

Originally Posted by scarry

I had a good GP here as well.
Then he went to a bigger clinic just around the corner.
No appointments so it has become pot luck.
Go there and i usually have to wait a couple of hours to see him,at least,time i dont have.
Even to to see any doctor takes at least an hour or two, waiting around.

So on the days he starts at 7,i have to get there at 6.30 and stand in line,there is usually around 6 people already there.
Its becoming a PITA,maybe, unfortunately, i will move on.

Bloody Hell Paul!


I hope that won't apply to our local practice & so far so good, but I am concerned at the Indian folk buying up established practices, they already seem to be well into Geriatric Care. I suppose our dear olde reliable & trusted GP will not be there one day when needed & that will be a sad occasion.

C`est la vie I guess.

Originally Posted by Tote

There seems to be a bit of a fuss being made in some sections of the media about doctors "rorting" medicare at the moment. I am sure that if the medicare rebate actually came close to the cost of servicing patients the temptation to do this would be less. A question maybe for Navy Diver - how corporatised is the GP industry in general? It certainly isn't in Yass with most of the practices falling inn the realm of "small business", however I can see that corporate entities might be tempted to develop ever bigger groups of practices for which the temptation to deliver profits is more important than delivering services. This happen somewhat disastrously in the childcare industry with many big players going broke once the big corporates were forced to become more accountable.

I have witnessed some overservicing at my local practice with pathology reports requested in circumstances where they may be excessive and a solid push to move six monthly appointments to three monthly when there is not a good medical justification, but it is fairly low level. The medical industry does have a very influential lobby group in the AMA and any reform is difficult in the face of claims that "everyone will have to pay to see the doctor" that are raised every time the AMA is displeased.

Medicare fraud: Bulk-billing rates inflated through rorts

Regards,
Tote

I think Telstra Health and Telehealth types are trying to be the supermarket of health care. Some or many may even be an overseas Doctor taking some of those calls. Large corporate like Primary Health are a mixed bag of good and trash. With shockingly low out of date rebates Solo GPs are not viable I think.

Rorts are Billing items they should be using so It is a compliance issue. Care plan Item 721 723 are the ones that get up my nose. Only your regular doctor is allowed to bill them to help you access allied health care partly Medicare funded. .

We often find a person has walked in to a once off appointment and those items where billed out side the regulation/requirements. If I call Medicare to find out dates and let them know this RORT has occurred Medicare they do ZIP despite being able to see the items billed by Dr Shonky was never allowed under the rulz!

I know they are doing a compliance audit against a Doctor who bulk billed adding the bulk billing $5 incentive. The Doctor his staff added a health care card or similar which was not that persons.

Medicare can pick $5 bulk billing incentive yet I have never heard of them auditing the one hit wonders which take $100-200 odd from Medicare that they clearly should not! Those might add up to Several thousand per day - The BB incentive might be $100.

FYI The Medicare bulk billing incentive stops the day children turn 16! It should be when they finish school

It also give a few cent to Health care card and Pension Card Holders. It should apply to all retired people in my view!

rulz are not smart some times and not policed when they should and could be. Give me all the Medicare billing data and My prior Reconstructive accounting tool and I would have hundreds of people needing to give back millions to Medicare. Not going to happen sadly. Its easy to do.



Personally I would like just six items short Medium an complex at $ 40 $90 and $140 with a LONG consultation supplement and the same for unsociable hours being $100 more each. Over time for staff, Doctors and a security supplement if needed! My six is 9 items

Noting I just might sell to a corporate and run away. I would feel awful if the 8000 odd people who are often like family got shafted by that. Much prefer to sell to a GP or two in a partnership.
.

In the UK your GP practice is not part of the NHS they are contractors to the NHS and charge the NHS a standing fee for each person they have on the books.

A profitable person never shows their face in the surgery. Then fees for a visit or to refer them to a service which they may themselves own which will charge the NHS again.

They are paid bonuses for things like the flu jab for hitting targets. This can result in all sorts of requests from doctors who you are not connected with to come in the have what ever is the latest so they can hit their target

Do not upset them as they have the absolute right to remove you from their books and if they do this tell
All the other practices they have done this. As accepting someone into the practice is at the discretion of the surgery this can make it difficult to find another doctor.

Generally see patients 4 hours a day Monday to Friday but not on a Wednesday or weekends. Seems the rest of the time is spend on paperwork

There are US based heath firms buying up the practices. Which seems a strange thing to do as the doctors claim they are loss making

The Wednesday & weekend thing is more likely Golf.

Originally Posted by NavyDiver

I think Telstra Health and Telehealth types are trying to be the supermarket of health care. Some or many may even be an overseas Doctor taking some of those calls. Large corporate like Primary Health are a mixed bag of good and trash. With shockingly low out of date rebates Solo GPs are not viable I think.

Rorts are Billing items they should be using so It is a compliance issue. Care plan Item 721 723 are the ones that get up my nose. Only your regular doctor is allowed to bill them to help you access allied health care partly Medicare funded. .

We often find a person has walked in to a once off appointment and those items where billed out side the regulation/requirements. If I call Medicare to find out dates and let them know this RORT has occurred Medicare they do ZIP despite being able to see the items billed by Dr Shonky was never allowed under the rulz!

I know they are doing a compliance audit against a Doctor who bulk billed adding the bulk billing $5 incentive. The Doctor his staff added a health care card or similar which was not that persons.

Medicare can pick $5 bulk billing incentive yet I have never heard of them auditing the one hit wonders which take $100-200 odd from Medicare that they clearly should not! Those might add up to Several thousand per day - The BB incentive might be $100.

FYI The Medicare bulk billing incentive stops the day children turn 16! It should be when they finish school

It also give a few cent to Health care card and Pension Card Holders. It should apply to all retired people in my view!

rulz are not smart some times and not policed when they should and could be. Give me all the Medicare billing data and My prior Reconstructive accounting tool and I would have hundreds of people needing to give back millions to Medicare. Not going to happen sadly. Its easy to do.



Personally I would like just six items short Medium an complex at $ 40 $90 and $140 with a LONG consultation supplement and the same for unsociable hours being $100 more each. Over time for staff, Doctors and a security supplement if needed! My six is 9 items

Noting I just might sell to a corporate and run away. I would feel awful if the 8000 odd people who are often like family got shafted by that. Much prefer to sell to a GP or two in a partnership.
.

I had occasion to use a "Specialist" some years back for Post Hospital "Care". They insisted on Cash each time. & had no Facility for plastic. Eventually we realised I was being used as a Cash Cow & after 'er indoors reminded him to wash his hands after his lunch time visit to somewhere else (? a hospital we believed) we gave him the flick & saw our GP for those visits instead. All he (#1) did was check ankles (?) & take BP & ask how I was all for $300 per visit.


His waiting room was always chockas & $300 notes from everyone there was a nice little earner for a Saturday arvo, but did he charge Medicare as well? Who knows? From what you have alluded to, most probably.


His wife was always cooking him a Chinese lunch out the back of the Waiting Room if you get me drift.

My real GP pricked his ears up when we mentioned this to him but maybe he has got the arse by now. Dr Ned Kelly we named him.

Telehealth is a good thing as it keeps people in touch with their doctors, particularly if they are remote or immobile so having to visit the surgery is difficult. Glad to see this week's announcement it is being reinstated, after being axed by the previous government.
For example, this week I needed prescriptions renewed, but my GP is fully booked to early November. A phone call to check my condition had not changed and the prescriptions were texted to my phone. Very efficient.

BTW last time I checked the Medicare levy only covered about half the actual cost of Medicare, so I support the levy being raised, since we would know it was all going into health.
I also think the Medicare rebate to doctors should be unfrozen, which should result in more bulk billing.
I also believe the federal share of public health funding should be restored to 50%, instead of expecting the states to cover 60%, to fund more beds and reduce ambulance ramping.
More beds would be released if more aged care places were funded, rather than having several thousand hospital beds (500 in Qld alone) filled with elderly people who are too frail to be sent home and should be in nursing homes.

Originally Posted by DiscoMick

Telehealth is a good thing as it keeps people in touch with their doctors, particularly if they are remote or immobile so having to visit the surgery is difficult. Glad to see this week's announcement it is being reinstated, after being axed by the previous government.
For example, this week I needed prescriptions renewed, but my GP is fully booked to early November. A phone call to check my condition had not changed and the prescriptions were texted to my phone. Very efficient.

Telehealth is a great idea for some,although our local Doctor will only do it two days a week,at a certain time,from memory between 12.00 and 1.00PM,and of course it is fully booked for weeks.