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You had initially referred her to the specialist and that referral had expired. Under the provisions in the Commonwealth Health Insurance Act, stiff penalties can apply for making false or misleading statements in relation to Medicare. An indefinite referral to the specialist or consultant physician can be provided where appropriate.

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Consider a courtesy call to the specialist rooms, reminding them that requests for backdated referrals will be refused and are unlawful. Read the original article here. In those cases the patient must declare to the specialist that a referral was completed by a referring practitioner, but was not delivered to the specialist because it was lost, stolen or destroyed.

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They can feel an obligation to help their patient who will otherwise be left out of pocket without a current referral. It is important to note that the usual month time period for referral validity starts at the time when the specialist first sees the patient, and not when the initial referral is dated. Ensure all practice staff and patients understand why a valid referral is important, and what constitutes a valid referral. The patient must be able to provide to the specialist the name of the referring practitioner and the practice address or the provider number of the referring practitioner.

Requirements for valid referrals A valid referral is required before a specialist can itemise the consultation so the patient is eligible for Medicare benefits. Reception staff should be trained and equipped to caringly and politely push back requests from patients for backdated referrals. References to the relevant legal provisions are also provided.

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Provision is made for situations when referrals are lost, stolen or destroyed. There are also situations where referrals are not necessary, such as pre-anaesthetic consultations, emergencies and referrals of private patients in hospital.

However, there is no leeway in this situation. If the specialist on-refers to another specialist, the specialist referral is only valid for three months.

Avant - What to do when a patient requests a backdated referral

Accounts for medical fees must contain particular information for a Medicare benefit to be paid. This article was first published in Medical Observer. The following summary information has been compiled to explain, in the simplest terms, totally free dating sites south africa the Medicare benefits rules for referrals and the implications of not adhering to them.

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In some situations, provisions are made for Medicare benefits to be paid if a referral has been lost, stolen or destroyed. You may wish to have a notice displayed in your waiting room about referrals which may remind patients about requesting an updated referral if theirs may be out of date. When referring patients to a specialist, emphasise why a valid referral is important and the time the referral is valid if they are having ongoing care from the specialist. Knowingly making a false or misleading statement carries a much higher penalty than accidentally makinga false or misleading statement.

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