Medical billing
& claims
Claims prepared and submitted, rejections diagnosed and resubmitted, private invoices raised and payments reconciled — so the practice gets paid for the work it has already done.
Rejected claims are just unbanked revenue
Every practice has a pile of rejected or unreconciled claims that nobody has time to work. A wrong item number, a missing referral date, a patient whose details changed — each one is small, and collectively they are thousands of dollars sitting in limbo.
The reason they sit there is not difficulty. It is that the person who could fix them is also the person answering the phone and processing today's billing.
A dedicated billing officer works the whole cycle including the rejections, which is where the recovered money usually pays for the role several times over.
What they process
- Claim preparation and submission — Bulk bill, DVA and private health claims prepared and submitted through your practice software against the right item numbers.
- Rejection recovery — Every rejected line diagnosed, corrected and resubmitted — the highest-value part of the role.
- Private invoicing — Invoices raised, gap amounts calculated from your fee schedule, statements issued.
- Payment reconciliation — Remittances matched to claims, short payments identified and pursued rather than absorbed.
- Debtor follow-up — Outstanding patient and third-party accounts chased on a fixed cadence.
- Fee schedule upkeep — Your fees and item numbers kept current as the MBS changes, so claims do not start failing quietly.
- Reporting — What is claimed, paid, rejected and outstanding — weekly, so problems surface in days rather than quarters.
What stays with your practitioners
Billing is administrative, but item number selection has a clinical basis. The line sits at whether the service was delivered as billed.
- Item number determinationWhich item reflects the service delivered is a practitioner decision. A billing officer applies it and queries anomalies.
- Clinical documentationWhat the notes say stays with the practitioner. Billing works from them, never rewrites them.
- Provider number useClaims are submitted through your practice software under your governance, not by someone holding provider credentials personally.
- Compliance decisionsAnything that looks like an MBS compliance question is escalated to the practice principal.