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Medicare Billing, Law and Practice: Complex, Incomprehensible and Beginning to Unravel
Margaret Faux, Jonathan Wardle and Jon Adams*
Australia’s Medicare is still widely considered one of the world’s best health systems. However, continual political tinkering for 40 years h…
Holding up a mirror to Medicare – do we like what we see?
“This article is one for the serious Medicare, medical billing and health insurance nerds. In it I have unpacked the Australian Medicare and medical billing legislation and demonstrated where the gaps are in p…
The study referenced in the Australian Doctor article and published in BMJ Open 2018 was led by Synapse CEO Margaret Faux.
GPs are being exposed to the “unnecessary risk” of falling foul of Medicare rules because so few organisations are willing to provide guidance on ho…
You’re likely guilty of this, so beware: the law trumps Medicare advice on bulk-bill vouchers
Having patients sign the vouchers – and then filing them in a place other than the bin – is more important than you might think.
Make one false move with Medicare and you’ll end up i…
Jennifer Dogget, Editor for Croakey, is writing a series of health columns for Inside Story. In this article she weighs in on out of pocket expenses with quotes from Synapse CEO Margaret Faux:
Fast-rising medical expenses are restricting access to healthcare and increasing long-…
Of all the things a trainee medical practitioner must learn, how to bill their patients is one of the most problematic.
A single Medicare service can be the subject of more than 30 different payment rates, myriad rules and strict penalties, including custodial sentences, for no…
The following is an excerpt from the DFAT India Economic Strategy by Mr Peter N Varghese AO
CASE STUDY:
Synapse: A successful model of integrated service delivery for Australia and India
Australian company Synapse Medical Services has found an opportunity to …
Everyone involved in the practice of healthcare is expected to know how to bill correctly yet it’s not being taught in any systematic or organised fashion by anyone.
Synapse Principal and CEO Margaret Faux has been studying this issue in her PhD thesis, this article published …
Pulse+IT article – Synapps MBS launch
Written by Kate McDonald
First published by Pulse+IT on 9/7/2018
Sydney medical billing, clinical coding and medical transcription specialist Synapse has launched a new rules engine-based app called Synapps MBS, aimed at ensuring Medic…
Fourth in series – Articles on out of pocket medical expenses.
The legalities and practicalities behind bulk billing generally are not well understood, but in her latest contribution to Croakey’s ongoing #OutOfPocket series, Margaret Faux, aims to throw some illuminating l…
Third in series – Articles on out of pocket medical expenses.
It is quite possible that reading this article about the complexities of medical fees will furrow your brow and possibly even give you a headache. The issues it canvasses left at least one hospital executive sighi…
Second in series – Articles on out of pocket medical expenses
In her previous post in Croakey’s #OutOfPocket series, Margaret Faux acquainted us with Section 51 (xxiiiA) of the Australian Constitution, which enshrines doctors’ right to set their own fees, regardless of gov…
First in series – Articles on out of pocket medical expenses
Out of pocket healthcare costs are set to be one of the health politics/policy issues for 2018. In this recent Croakey post author Margaret Faux provides some history on the topic along with an outline of the issue…
Australian private health insurers (PHI) have an image problem. They are never out of the headlines for long, are criticised for inappropriately profiteering from a $6 billion government handout and still their products seem to offer poor value and satisfy no one. Margaret Faux d…
Recent Australian Institute of Health and Welfare report reveals that patients in public hospitals with private health insurance have short waiting times for elective surgery than those without private health insurance. Margaret explores behind the headlines in this article.
h…
A Ministerial Advisory Committee on private health reform has proposed an increase in Medicare rebates as a way of reducing out-of-pocket costs when rural patients require inpatient services. It seems logical but will it really achieve its objective? In this article Margaret expl…
In this article recently published in The Medical Republic, Margaret Faux discusses the myth that 85% of GP services are bulk billed. Please click on the below link to read this fascinating article.
http://www.medicalrepublic.com.au/lies-damned-lies-medicare-bulk-billing-rate…
In this podcast recorded live on ABC overnights Margaret Faux discusses the federal government’s plans to privatise Medicare in the context of the 2016 Federal Election….
Medicare expenditure on after hours GP services has risen dramatically in the past year. But does it really keep patients out of Emergency Departments. Margaret Faux chatted with Ellen Leadbeater on 2SER FM’s Think Health about the rise in after hours care. Listen to the full tra…
We have come to expect that our politicians will dismiss each other’s policies as scaremongering when it’s expedient to do so. But we demand more of our journalists, whose job it is to provide balance and perspective. Last night the ABC let us down in this regard when it comes …
Margaret Faux’s recent Croakey post, republished on the Medical Republic, explaining the devastating impact an end to bulk billing will have on patients. Read the full article on medicalrepublic.com.au…
In this recent Croakey article, Margaret Faux explains the real impact of the freeze on patients and how use of the term ‘co-payment’ is misleading and often poorly understood.
Read the story in full on Croakey.org…
Medicare is one of those things that’s distinctly Australian but does it need to adapt to the times? Margaret Faux is a lawyer, registered nurse and founder of Synapse Medical Services.
Her PhD is entitled “Claiming and compliance under the Medicare Benefits Schedule: A critic…
2ser 107.3 take a look at the health professional behind your Medicare transaction.
How knowledgable are they about rebates? Could the government save money by investing in Medicare training for doctors? They speak to Margaret Faux, a PhD student in the Faculty of Health at th…
In putting out an SOS for the Medicare Benefits Scheme, Margaret Faux says what we need is a thorough examination of the way it is used, along with a truly sustainable solution.
Seeking a Cure (488 KB)
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Medicare provider numbers can prove to be a minefield for anyone practising in more than one location. There’s a lot of myth, not a lot of substance and woe betide anyone who dares to travel beyond the horizon. By deciphering fact from fiction, Margaret Faux provides some clari…
While Telehealth is a rational approach to addressing specialist shortages in rural and remote parts of the country, Margaret Faux says there are complex issues for all practitioners to get to grips with.
Access All Areas (1229 KB)…
Worried about whether your referrals would stand up to scrutiny in a Medicare audit? In the interest of clearing up your concerns, Margaret Faux undertakes the forensics on this complex subject.
The Rules on Referrals (1364 KB)…
Margaret poses the question: when do you have a contractual relationship with your patient as a service provider, when billing your patient?
Contracts, Claiming and the Colon (2112 KB)
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Uncertain about the Medicare rules on charging for bandages and
other consumables? Margaret Faux outlines your options.
Claiming on Consumables (1087 KB)…