Newsletter – June, 2011

As many of you would already know, HCF purchased Manchester Unity in December 2008. The final stage of that merger will be completed on 30 June 2011.

All Manchester Unity members are being provided with new HCF membership cards during the month of June. These cards will be active from 11 July 2011 and must be used exclusively as and from that date.

So from 11 July 2011 any Manchester Unity patient memberships will be invalid.

We will be keeping an eye on this for you and will be in regular contact with HCF regarding any claims that are rejected due to membership number issues.

On Monday 30 May 2011, Medibank Private went online for Eclipse claiming. We transmitted large volumes of claims using the new Eclipse channel on your behalf and unfortunately, all of these claims were processed incorrectly and were paid only at the schedule fee rather than at the Gapcover rate (more than 25% less!).

After speaking with Medibank we discovered that the cause of the incorrect payments was Medibank’s unique requirement that we must tick a box indicating that written informed financial consent (IFC) has been provided for all Gapcover claims. This is despite the fact that there is no legal requirement to do so and that no other fund has such a requirement.

We are of the view that to comply with this requirement would amount to a false declaration for each and every claim submitted and therefore, on Wednesday 8 June 2011 we stopped all electronic claiming to this fund and have reverted to paper-based claiming.

Interestingly, the Medibank Private batch header for paper Gapcover claims clearly states that written IFC is not required where there is no patient out of pocket expense – which reflects the correct legal position.

So if we’ve got this right, written IFC is required for electronic claims but isn’t for paper claims using the one and the same Medibank Gapcover scheme. Another unfathomable inconsistency, or in the vernacular…… go figure!

Given that most doctors who choose to use the Gapcover system do so to benefit patients, one must question why Medibank would add this burden for doctors who, to comply, would need to provide written advice to every patient they consult in a hospital bed to the effect that the patient won’t have to pay anything.

If this is of concern to you please tell your College or if you are an AMA member please let them know. You might even want to call Medibank on 1300 130 460 or email them at medical_provider@medibank.com.au.

In the meantime, we have stopped all online claiming to Medibank and will be batching and sending paper claims until further notice. We have also arranged for all of the incorrectly processed claims to be topped up to the Gapcover rate and will be closely monitoring the progress of these claims to ensure they are correctly paid. So don’t worry, we are onto it and rest assured all of your claims will be correctly paid. Stay tuned for the next installment.

Well it’s not quite this bad but it’s getting close.

As part of our service to you the Synapse team spends hours on the phone everyday to the health funds, Medicare, Veterans, other providers, the workers comp insurers to name but a few, obtaining updated information, checking membership numbers, obtaining provider numbers and so on. It’s our job and we love it!

But we are finding that we have to jump through more and more hoops to get to first base with many of those who we call. It’s the world of privacy that we live in and we just have to roll with it. And whilst we have extensive online facilities which give us direct access to much information, sometimes we just have to get on the phone.

You can help us by providing as much information on your consultation records as possible for every patient, remembering that without a date of birth as a bare minimum, the person on the other end of our call will simply hang up.

Here’s a transcript of a fairly realistic encounter we experience when there is a date of birth issue:

Health Fund (HF) – Thank you and the patient’s date of birth please?
Synapse (S) – 23 / 4 / 51.
HF – Sorry that’s not what we have.
S – Oh I see. It seems to be verifying correctly with Medicare.
HF – Sorry we have a different date of birth.
S – Is it out by a lot?
HF – I am sorry I cannot tell you that.
S – I understand. Hmmmm (long pause). We have 23 / 4 / 51 and what did you say you have again?
HF – (if we’re lucky!) 24 / 4 / 51.
S – I see. Thanks for your help, I’ll take it from here and see how I go.

So thanks for paying attention to the details – especially those of you who hand write patient information.

Pocket Dictate makes your iPhones go off!

Pocket Dictate is a free application for iPhones that turns your device into a dictaphone.  And for those of you who use Just Your Type we can configure the application to send your files securely to our FTP server ready to be picked up by our medical transcriptionists.

“It’s amazing, I just use my iPhone like a dictaphone, press a button and the dictation is sent through straight to the transcription service – my patients are so impressed with how savvy I seem!” (Physician, Sydney).

Please contact us if you’d like to find out more.

The Private Practice is offering a 25% discount to Synapse clients for the upcoming Employment and Practice Management, one-day intensive course in Sydney next weekend. See details below.

If you’d like to attend just call Steven Macarounas on (02) 9362 5050 and inform him that you are a Synapse client. I hope to see some of you there.