Telehealth in Australia: Embracing Change and Navigating Compliance
Welcome to the first in a series of blog posts designed to accompany Medcast's Business Practice webinars, focusing on a particularly pertinent topic: telehealth billing compliance.
Our focus here, as we reiterate throughout the series, is building confidence. We know that doctors that are not confident with their billing will underbill. Occasionally doctors that don’t understand the legislation overbill. Our aim is to help you know the rules and feel confident in your billing so that you can appropriately charge for the care you give, and sleep well at night knowing it all complies!!
This series aims to serve as both a precursor and a supplementary guide for Australian General Practitioners (GPs) and GP practice staff who seek to understand and navigate the evolving landscape of telehealth.
I'm Dr. Stephen Barnett, the founder and Medical Director of Medcast and a GP practice owner in the Southern Highlands, New South Wales. Alongside Loryn Einstein, the Managing Director of Medical Billing Experts, we're here to demystify the complexities of telehealth billing practices.
Telehealth has seen an unprecedented evolution over the last few years, particularly catalysed by the COVID-19 pandemic. What began as a service primarily for rural and regional areas has expanded to encompass metropolitan services, driven by necessity and innovation. The rollout of telehealth and phone item numbers, which began in March 2020, signalled the start of a new chapter in patient care—one that continued to develop throughout 2021 and 2022.
As we settle into what might be considered a new normal, we find ourselves reflecting on the journey telehealth has taken. From its rapid expansion to the stabilisation of telehealth items made permanent in January 2022, it's been a whirlwind of adaptation and learning. This has been not without controversy and new compliance issues such as the 30/20 rule which we will talk about later on, and the recent controversy around verbal assignment of benefits- an issue still not fully resolved.
A post-implementation review of these item number changes, released in September 2023, provides valuable insights into the effectiveness of these billing items and the potential areas for improvement, providing us with some idea of what to expect over the next couple of years.
We will explore the recently updated item numbers and the incentives introduced under MyMedicare. Our aim is to provide clarity and guidance in a landscape that, while confusing at times, has shown significant benefits for both practitioners and patients alike.
As we navigate this series together, remember that the information provided is for educational purposes. We encourage you to seek personalised advice for your practice to ensure compliance with the most current regulations.
Telehealth has indeed been one of the silver linings of the pandemic, accelerating not just the adoption of remote healthcare but also its integration into Medicare. However it has moved so quickly that staying up to date is essential. Stay tuned for our next instalment, where we delve deeper into the specifics of telehealth billing and compliance.
Mastering Medical Billing
To access more resources including webinars, blog posts, learning activities and more, visit the Mastering Medical Billing hub.
Stephen is a GP Supervisor, Medical Educator, GP academic and Medical Director of Medcast. He has completed a PhD on Virtual Communities of Practice in GP Training.
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MBS item 23 is one of the most commonly used item numbers in general practice - but also features frequently in Medicare compliance issues. Clear up your confusion with this FastTrack fact sheet, including a breakdown of its key features and common compliance pitfalls. Earn 30mins RP and 30mins EA CPD with completion of the quiz.
At the core of general practice is the consultation. In its simplest form, the consultation can be regarded as the sharing of information between patient and doctor in order to facilitate both a common understanding and a plan of management.
Accurate documentation for telehealth billing for Australian General Practitioners is essential. A recent case highlighted compliance issues, urging meticulous clinical notes for proper billing. Balancing audit fears and underbilling is a challenge, and templates are helpful if used judiciously and with detailed notes.