Medicare claiming outage leaves general practices in limbo

Organisations faced other tech issues

Medicare claiming outage leaves general practices in limbo

Insurance News

By Roxanne Libatique

General practices across Australia are in limbo due to a Services Australia outage, delaying online claiming in Medicare, PBS, and the Department of Veterans' Affairs (DVA).

Lyndy Ronan, a nurse and practice owner at the Yarrawonga Medical Centre, said she became aware of the claiming outage on Monday – a public holiday in Victoria – when the issue was highlighted on a Facebook network for practice managers. However, the issue persisted on Tuesday.

“On and off all day, we couldn't access Medicare,” Ronan told newsGP, noting that the practice did not receive any notification about the issue.

Other tech issues

Aside from facing delays due to the online claiming outage, the general practice staff could not carry out online patient verifications because the issue affected access to the PRODA online identity verification and authentication system and the Australian Immunisation Register.

“It was an extra workload for my staff; we couldn't batch up all of our Medicare claims,” Ronan said. “[It was] my poor receptionists who bore the brunt of it.”

Ronan said that the outage length was unusual: “From time to time, it will just drop out. Normally, it's only for an hour or two, and they'll send an apology email, but this time, there was nothing.”

Services Australia's response

On Tuesday, Services Australia contacted the affected organisations, including general practices, pharmacies, and hospitals.

“Medicare, DVA, and PBS online claiming are gradually returning to maximum capacity following a planned system update over the weekend,” it said. “Some of your patients may experience delays in having their rebates processed while we return to maximum capacity.

“Claim processing will return to normal as soon as possible. You will be able to re-submit any transactions that cannot be processed immediately. We apologise for any inconvenience this has caused you and your patients.”

Calls for Medicare overhaul intensify

Calls for Medicare overhaul had intensified even before the claiming outage as a decade of neglect made it more challenging and expensive to go to doctors, according to the Albanese government.

“For the first time in the history of Medicare, the average gap fee for a standard GP consult is more than the Medicare rebate itself ... And that's having a real impact on the general operation of our health system,” Health Minister Mark Butler said, as reported by The Sydney Morning Herald.

“The constant advice we have received across the country is that after nine years of cuts and neglect to Medicare, it has never been harder to see a doctor, and never more expensive – with bulk billing rates in decline, and gap fees constantly going up – than it is right now.”

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