Medicare - Health Professionals 012-40000000
Expand allThis document outlines information about health professionals and Medicare services and benefits.
Government intent
Services Australia administers Medicare on behalf of the Department of Health and Aged Care, who is responsible for developing Medicare policy.
Services Australia pays Medicare benefits in accordance with legislation governing Medicare and has no discretion to pay benefits outside of this legislation.
The Medicare Benefits Schedule (MBS) is a Department of Health and Aged Care publication that lists services that are subsidised by the Australian Government under Medicare.
Medicare usually covers:
- free or subsidised treatment by health professionals such as doctors, specialists, optometrists and in specific circumstances dentists and other allied health practitioners
- free treatment and accommodation as a public Medicare patient in a public hospital
- 75% of the Medicare Schedule fee for services and procedures if a person is a private patient in a public or private hospital. This does not include hospital accommodation and items such as theatre fees and medicines
- some health care services in certain countries
Contents
Payment pay group link for Medicare benefit cheques
Suspected Medicare fraud and Business Integrity (BI) flags
Payment Accuracy Review (PAR) process
Pathology processing in Medicare
Perform telephone security check for private health insurers in Medicare
Perform telephone security check for Medicare health professionals
Assisting Doctors Complete Centrelink Medical Certificates (ADCCMC)
Hospital Provider Numbers (HPN)