What's new?

May 2009

We are running a regionally focused and targeted communication campaign to promote Medicare electronic claiming to Medicare cardholders. If your practice is in one of the targeted areas, you will receive a letter to inform you about the messages we are delivering locally.

For more information about patient claiming through Medicare Online and Medicare Easyclaim call 1800 700 199 to talk to one of our Business Development Officers.

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Audit & Compliance

Program Review & Integrity

Review provides information, counselling and education into the appropriate use of the Medicare Benefit Schedule, the Schedule of Pharmaceutical Benefits and other programs administered by Medicare Australia.

Program Review works with the health industry to:

ensure the correct benefits are claimed for properly rendered services
prevent and detect fraud and inappropriate practice with respect to claiming of benefits

Program Review uses advanced information management technology to collect, research and analyse health information to prevent, detect and investigate fraud and inappropriate practice.

Program Review encourages appropriate behaviour through education, interview and practice profile review processes under the Professional Services Review Scheme, and compliance activities.

In meeting Medicare Australia’s objective to ensure that payment of benefits is correctly made for services properly rendered, the Program Review function is responsible for preventing, detecting and investigating fraud and inappropriate practice.

Program Review applies a balance of education and compliance strategies to meet the requirements for the Health Insurance Act 1973, National Health Act 1953, and the Medicare Australia Act 1973.

Using a comprehensive range of strategies, Program Review focuses these activities in the direction of service providers and the public who use the programs administered by Medicare Australia.