Health professional guidelines
The Department of Human Services and the Department of Health and Ageing, have been working with a number of peak bodies in the health sector to develop health professional guidelines.
These guidelines form a series designed to help health professionals understand what documents they can use to substantiate services if they are asked to participate in a Medicare compliance audit.
- Substantiating dental services where an eligible patient has been referred by a general practitioner under the Chronic Disease Dental Scheme [PDF, 336Kb]
- Substantiating specialist dental services where an eligible patient has been referred under the Chronic Disease Dental Scheme [PDF, 303Kb]
- Substantiating dental prosthetic services where an eligible patient has been referred under the Chronic Disease Dental Scheme [PDF, 300Kb]
- Substantiating services provided by an eligible dentist where a patient has been referred by a dentist, dental specialist or dental prosthetist under the Chronic Disease Dental Scheme [PDF, 326Kb]
- Substantiating that a patient attended a service [PDF, 489Kb]
- Substantiating that a specific treatment was performed [PDF, 474Kb]
- Substantiating that a valid referral existed (specialist or consultant physician) [PDF, 489Kb]
- Substantiating that a valid request existed (pathology or diagnostic imaging [PDF, 504Kb]
- Substantiating that the patient had a pre-existing condition at the time of the service [PDF, 500Kb]
- Substantiating that the requirements for an assessment service or group allied health service for a patient with type 2 diabetes have been met [PDF, 235Kb]
- Substantiating proof of malignancy where required for MBS items [PDF, 257Kb]
- Substantiating preparation of a valid GP Management Plan (for medical practitioners) [PDF, 231Kb]
- Substantiating coordination of the development of Team Care Arrangements (for medical practitioners) [PDF, 217Kb]
- Substantiating preparation of a valid GP Mental Health Treatment Plan (for medical practitioners) [PDF, 209Kb]
- Substantiating that a valid Allied Mental Health service has been provided (for allied health professionals) [PDF, 207Kb]
- Substantiating that valid individual Allied Health services were provided (for allied health professionals) [PDF, 230Kb]
For more information about the guidelines or to provide feedback, email compliance.co-design@humanservices.gov.au
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Last updated: 4 March, 2013