Bulk-Billing Primary Health Clinic


A consultancy project that Synapse has undertaken in 2022 has been to work closely with a bulk-billing primary health clinic that services a challenging population with complex needs.

Synapse was contracted, in a multi-phase project, to explore ways to ensure the future viability of the clinic.

The clinic exists to service the needs of disadvantaged populations who are unable to afford to pay an out of-pocket expense. Previous engagements had focussed solely on maximising Medicare revenue without looking at the compliance piece and other aspects of the practice, such as digital enablement and workforce design. Therefore, the problems had continued.

Synapse designed a bespoke three phase project for this client.

In the first phase, we analysed a dataset of one year of MBS claims. There were 10,426 invoices in total, spread across the medical practitioners working in the practice.

In phase two, we conducted a short quantitative survey examining MBS knowledge, and time utilisation and patient scheduling. Phase three comprised qualitative interviews with the medical practitioners.

Our final report included a holistic review and summary of all clinic processes including software, workforce, MBS billing compliance, and operational processes and workflows. The final recommendations included billing improvements such as rectifying under-billing, redesigning workforce utilisation, disposing of a legacy PMS, and piloting new technologies particularly in the revenue cycle area. We also introduced the client to a little known, but compliant Medicare billing option that is still in use in a small number of practices, which the client is very keen to trial.

This clinic is now well placed to embark on a program of robust, digitally driven change, that is MBS compliant and does not involve charging high out-of-pocket costs to their population, who simply cannot afford to pay.

Synapse is now in an ongoing consultancy relationship with the organisation to progress the recommendations.

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