The ABC asked experts to examine the records of several chronic pain patients to determine if any misbilling had occurred.Stakeholders, including medical practitioners and healthcare executives, have called for an urgent reform of the billing processes.
Her private health records show the incorrect billing occurred twice, once in October 2023 and again in February this year, which resulted in the overcharging of her private health fund more than $2,000 following a procedure known as nerve ablations, where a portion of the nerve is destroyed or removed to reduce pain.Questionable billing by some doctors is rife in Australia's medical industry.
The Four Corners program led to a flood of patients sending questionable billings to ABC investigations. "How did the fund even pay for this? How many others have they paid that they shouldn't have? How could it have been paid. How?" he wrote in an email to the clinic last June. When she called the anaesthetist's secretary to express her concerns, the response was: "this is how he always does it" but then agreed to refund a $500 fee the patient had paid.
It said as the body representing the professional standards of specialist anaesthetists and specialist pain medicine physicians, it supports an investigation of any allegations of overservicing, wastage, and unprofessional behaviour by the relevant federal regulatory authorities.
They described their findings of the three's billings as "troubling" and consistent with the trends found in the Kirontech/Synapse report."One hundred per cent of the anaesthetic claims we reviewed were questionable," they said. Dr Sutherland said the anaesthesia bills she reviewed with Dr Faux demonstrate what is happening in the current overly complex system.
"Not only was I left traumatised as a result of these brutal surgeries, I was left realising that I was a cash cow for the financial benefit of the practice," Mr Parker said. They noted other anaesthetic bills that didn't match the medical records included a 45-minute consultation and management plan, while Ms King was in a coma.
"Here we are seven years later, and the problems appear to have worsened at significant cost to taxpayers," Dr Sutherland said.
Source: Healthcare Press (healthcarepress.net)
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