Can doctors make claims without my knowledge?

[Rowellen]

I would think it is fair enough to charge you if you see the nurse as they don't have a separate nurses fee as far as I am aware. So the doctor has to pay the nurses out of their pay ITMS. Although I do think the dr should at least just see you even if only for a minute if only to cover their bums legally. When I have just seen the nurse at the practice I go to, the dr pops out between patients to make sure everything's hunky dory.

[~Raven~]

You would have had to give your Medicare card at casualty. That was in effect giving consent to charge the consultation to Medicare. If you don't give your Medicare card they will bill you the full fee.

[Mother Goose]

Some nurse things can be bulk billed - there is a special code. It's been a while since I've had anything to do with billing so I can't recall all the things they can bulk bill for. My memory is a little hazy but if the nurse doesn't have a provider number, it is bulk billed on the Dr's provider number but as a certain nurse task code.

Hopefully one of the practice nurses on here (and there are a few) can shed some light on it for you including if what they did is legal. My feeling is that it is NOT legal as I vaugely recall reading a case about a Dr who did this and got prosecuted (successfully). BUT, I could be wrong. As I said, it's been a loooooong time since I've done billing.

If you're not comfortable with it, feel free to call the rooms as ask them to explain it. You can call Medicare and they may chose to investigate.

[Astrid]

I remember when we have done anything with the Nurse at the clinic that she always asked which Dr we were under, so it would be bulk billed against them. This was for things like immunisations, ear syringing etc

[anney]

Nurse stuff they should be able to bulk bill for but I wouldn't think they could bill for the call from emergency where they looked up your records. Does the online medicare thingo have an item number against it?

[Floweryfields]

Yep the hospital one where I had the tetanus needle was item number 05020 level B surgery after hours at consulting rooms. As for having to present my medicare card, nope. Not even when I saw doctor today and definitely not at hosptial. I actually asked if they needed it and was told no, it was on file already.


From MBS site:

5020 CONSULTATION AT CONSULTING ROOMS

Professional attendance at consulting rooms. The attendance must be initiated either on a public holiday, on a Sunday, before 8am or after 1pm on a Saturday, or before 8am or after 8pm on any other day.

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting less than 20 minutes, including any of the following that are clinically relevant:

a) taking a patient history;

b) performing a clinical examination;

c) arranging any necessary investigation;

d) implementing a management plan;

e) providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation.

I would say looking up a medical history from home would be a stretch?

[Phteven]

I think that looking up your file and calling it a 1 hour consult is a bit rich. He would be within his rights to claim for after hours but IMO 30 minutes is a reasonable charge not an hour.