Medicare/Private Health Insurance audits and investigations

Meridian assists health practitioners in audits of billings conducted by Medicare Australia for PBD and MBS items. We are well versed in assisting and defending practitioners when the audit escalates to an investigation by the Professional Services Review Agency, including advising on options being a section 92 agreement or a committee hearing.

Our team also assists health practitioners in audits and investigations by private health insurers into rebates claimed, privacy advice, the interplay of HICAPS and other issues and drafting submissions concerning derecognition of service and review processes.

Key services

  • Advising on Medicare Australia audits into billings generally and under Government schemes such as the CDDS (Chronic Disease Dental Scheme)
  • Advising and defending Professional Services Review Agency investigations into billings for general practitioners and sleep physicians
  • Advising on private health insurer audits and investigations and reviews of derecognition status
  • Advising on changes to Medicare Australia rebates under the MBS