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Welcome Synapse Network,
We hope you’re keeping warm and well through these cooler winter months. We’ve been working hard behind the scenes here at Synapse and are excited to announce the launch of our new website to make your experience with us even better. My book for pa…
A large multidisciplinary pain clinic engaged us to conduct a comprehensive review of its medical billing compliance across outpatient, inpatient, and compensation scheme services.
Scope:
We assessed Medicare billing practices, rejection patterns, clinical documentation, referr…
Our client, a bulk billing general practice serving a complex and vulnerable patient population, sought our help to ensure the long-term sustainability of the clinic. Their goals were to:
1. Understand current billing patterns and identify opportunities for improvement
2. R…
Our client, a leading private provider of fertility services in Australia, approached us for advice on a nuanced Medicare billing issue involving a returning doctor. The clinician in question was an Australian-trained medical graduate who had spent over a decade overseas completi…
An internationally renowned health service provider engaged us to assess the viability of establishing a network of nurse-led urgent care clinics, potentially supported by GPs and Fellows of the Australasian College for Emergency Medicine (FACEM). The vision was to deliver high-q…
A primary care provider delivering services through group appointments approached us for a full compliance review of their Medicare billing. While Medicare generally does not support billing for group consultations, this provider’s model was highly specialised and unlike anythi…
A medical specialist engaged us after discovering that fraudulent claims had been submitted in her name – over 1,100 services across a nine-month period. Despite acting quickly and in good faith, she received no support from her medical defence organisation or any other body.
…
Dear Synapse Network,
We hope 2025 is already shaping up to be a good one for you. Here at Synapse, it’s been a very busy first quarter. We have released improvements to our flagship billing platform, announced a new #express code service, brought on new clients and I’ve w…
Welcome to our annual Christmas update
So here it is, Merry Christmas! Another year has flown by.
In November, we brought you a full update on activities across our services, so I thought I’d make our Christmas message a bit different this year and tell you more abo…
Dear Synapse Network,
There’s been a lot going on in Synapse world so we thought we would provide a quick update before our annual Christmas newsletter.
We’ve been involved in more media stories, attended conferences, added hundreds more rules to our rules engine and ha…
A venture bringing together innovative Australian companies to deliver real value to private hospital operators
The Arcadia Pittwater Private Hospital has now joined Sydney private hospital Matilda Nepean in implementing a combined digital health platform consisting of Global …
We congratulate Dr. Margaret Faux, on her election as Director on the IACC’s Board during the 2024 AGM held in October. Dr Margaret Faux is CEO and Founder of Synapse Medical Services, a highly successful health system lawyer and academic with deep experience and knowledge of h…
Exciting news in the Australian digital health space with Synapse Medical and Matilda Nepean private hospital announcing an Australian partnership to manage the digital revenue cycle of the leading Sydney hospital.
This integration means we are stronger together in digital hea…
Kirontech and Synapse enter into an International healthcare payment integrity partnership which will build on work they did in 2024 for the ABC and continue exposing fraud, waste and abuse in the Australian health system and around the world. Data analysis and future reports are…
The ABC reported on bulk-billing breaches by some GP’s, in the latest investigation into Medicare billing practices by medical professionals.
When consulted about clinics charging membership fees while bulk-billing, Dr Margaret Faux said, that these breaches could …
Dear Synapse Network,
A Welcome to our Winter 2024 newsletter.
There’s been a lot happening across all our locations recently. It was a very busy Autumn!
We’ve been involved in national media stories, had world conferences to attend, made huge advances in our AI clin…
Advance Health May session, ‘Shattering Stigma Through Mental Wellbeing’ brought together key stakeholders to discuss how to improve patient’s mental health journey in healthcare and how to remove barriers to care.
Watch the full session Advance Health: Shattering Stigma Throu…
Our client, a major player in the Australian healthcare market, engaged us to conduct a detailed Medicare billing review as part of due diligence for a potential acquisition. The target business was a large, multi-site general practice operation with over 200 GPs contributing to …
This report was prepared for the Australian Broadcasting Corporation to assess payment integrity in spinal surgery billing, as part of a broader investigation into chronic low back pain.
Our brief was to analyse private health insurance inpatient billing for spinal surgeries t…
Our client, a state government regulator overseeing workers compensation schemes, engaged us to assess the integrity of medical practitioner billing and claims management processes.
Following initial discussions, we agreed to a proof-of-concept project. Synapse was tasked with…
Dr Margaret Faux was engaged to provide an independent expert opinion regarding the Medicare billing compliance of a medical specialist under review by the Professional Services Review (PSR) Agency. The PSR is responsible for investigating whether services billed to Medicare comp…
Dr Margaret Faux was engaged to provide an expert opinion in a high-stakes matter concerning the Medicare billing practices of a medical specialist working within a public hospital setting. The case formed part of a formal state inquiry examining the conduct and compliance of med…
Margaret and other health professionals call on the government to give greater powers to the Professional Services Review Agency to conduct national medical records audits.
Anaesthetist Joanna Sutherland (chair of the Safety and Quality Committee of the Australian and New Zealan…
Another informative article from ABC Investigations, published on May 1st 2024, about the fraud, waste and abuse by some medical professionals within the Medicare billing system. This time with a focus on questionable billing by Anaesthetists.
Dr Sutherland, Dr Peck and I have…
Margaret talks about Medicare fraud vs error as it often comes up and is a legitimate concern.
The difference between error and fraud is the intention, which is difficult to prove. When it comes to our nation’s medical billing scheme, the misuse – whatever the intention – is far…
In this post Margaret explains how we identify alarming Medicare use.
We analyse healthcare data often, applying global standardised criteria to identify continual discrepancies in what is being billed versus what we would expect to be billed. These criteria factor in the comple…
Margaret is often asked why she speaks out about bad Medicare billing behaviour, here is what she has to say.
Having worked for many years at the interface of patients, payers and providers, it has become obvious that no one is happy about or trustful of our healthcare funding a…
History has shown us that the most meaningful changes have come about because of uncomfortable truths.
It is unfortunate that Australian doctors are currently working within a broken healthcare system that lacks transparency, checks and balances. This allows the misuse by some, …
Read about the very personal stories of those that have suffered complications due to surgical intervention as seen in the Four Corners April 2024 episode Pain Factory.
Read The Endless Pain full article here
by Adele Ferguson and Chris Gillett, ABC Investigations…
Published 8 Apr 2024
Adele Ferguson and Chris Gillett, ABC Investigations
Four Corners has obtained the private health insurance billing records in a major investigation into the chronic pain industry.
The patient records were analysed to Dr Faux and a team at Synapse, a…
