For Australian GP clinics, Medicare billing is essential to financial sustainability, but it’s also one of the most error-prone and administratively demanding parts of practice management. From incorrect item numbers and missing documentation to eligibility oversights, billing mistakes can delay reimbursements, reduce cash flow, and increase compliance risks.
As clinics become busier and patient expectations rise, more practices are turning to Business Process Outsourcing (BPO) partners to streamline their Medicare workflows. A skilled BPO team can reduce errors, improve the speed of Medicare payments, and free up clinicians and reception staff to focus on delivering high-quality patient care.
Below, we break down the most common Medicare claim pitfalls in general practice and explain how specialised BPO support helps clinics avoid them.
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Incorrect or incomplete use of item numbers
The challenge:
MBS item numbers can be complex, especially when rules vary based on consultation length, patient eligibility, telehealth versus in-person services, time of day, or relationship to a previous appointment. Small administrative oversights – such as billing the wrong level of consultation or using a time-based item when the minimum duration wasn’t met – can cause claim rejections.
How BPO helps:
BPO billing specialists are trained in Medical Benefit Schedule (MBS) requirements and routinely cross-check appointment notes, consultation times, and MBS rules before claims are submitted. By ensuring item numbers align with documentation, clinics see fewer rejected or adjusted claims.
- Missing or insufficient clinical documentation
The challenge:
Medicare requires documentation that supports the item number being billed. For example, certain GP Management Plans, health assessments, and mental health items have strict content and recording requirements. If documentation is incomplete, Medicare may reject the claim or request additional evidence.
How BPO helps:
A BPO team can audit clinical notes and ensure the necessary components are present before a claim is lodged. This protects clinics from compliance issues and saves time that would otherwise be spent responding to Medicare queries.
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Overlooking eligibility requirements
The challenge:
Some items are claimable only once every 12 months; others require a valid referral, a chronic condition diagnosis, or patient consent. Fast-paced clinics may overlook eligibility checks, resulting in delays or non-payment.
How BPO helps:
Outsourced billing teams build automated or manual eligibility checks into the billing workflow. By verifying patient history, previous claims, referrals, and required forms, BPO staff ensure eligibility criteria are met before claims are submitted.
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Delayed claim submission and reconciliation
The challenge:
Busy clinics often fall behind on batching, submitting, and reconciling Medicare claims. Delays cause cash-flow bottlenecks and make it difficult to track rejected claims before they become harder to resolve.
How BPO helps:
BPO teams efficiently process claims daily, reconcile payments, track outstanding items, and promptly follow up on rejections. This improves revenue predictability and gives practice managers clear, real-time financial visibility.
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High administrative burden on clinical and reception teams
The challenge:
GPs and reception staff often juggle a heavy administrative workload with patient-facing duties. Medicare billing errors increase when staff are rushed or multitasking, especially in clinics without dedicated billing support.
How BPO helps:
A BPO partner takes over the most time-consuming parts of billing – including coding, checking, submitting, and reconciling claims allowing clinicians to refocus on patient care and front-desk teams to improve service quality and reduce wait times.
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Lack of consistent quality control
The challenge:
Without standardised billing workflows, errors can become systemic. Different staff may apply item numbers inconsistently, interpret rules differently, or miss changes to the MBS.
How BPO helps:
BPO providers implement standard operating procedures, routine audits, and cross-checking systems to maintain consistency. They also monitor MBS updates and adjust workflows immediately, ensuring clinics stay compliant year-round.
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Improved cash flow and financial stability
Accurate billing means faster reimbursements and fewer rejected claims. With BPO support, clinics benefit from predictable cash flow, better financial reporting, and reduced administrative costs, helping practices reinvest in staff, equipment, and patient care initiatives.
Why GP clinics choose Flat Planet for Medicare billing support
Flat Planet offers trained, healthcare-literate teams who are familiar with the issues surrounding MBS claiming, patient privacy, and Australian healthcare workflows. By partnering with Flat Planet, clinics gain several advantages:
- Fewer billing errors and faster reimbursements
- Daily submissions, reconciliations, and follow-ups
- Strong documentation and compliance processes
- Enhanced patient experience at reception
- More time for clinicians to focus on care rather than paperwork
Outsourced billing isn’t just about efficiency; it’s about giving GP clinics confidence that their revenue cycle is accurate, compliant, and running smoothly behind the scenes.
About Flat Planet:
Established in 2010, Flat Planet® is a family-owned, Australian-operated leading provider of high-value outsourced staffing solutions. Connecting businesses worldwide with skilled talent in Southeast Asia, offering a competitive edge through cost-effective, high-quality staffing solutions. With offices in the Philippines, Vietnam, and Malaysia, we employ over 400 staff serving global clients. Our state-of-the-art infrastructure, combined with a blend of local and Australian management practices, ensures excellence in service delivery. At Flat Planet, we are committed to creating pathways to a brighter future by providing businesses with access to a globally competitive workforce and supporting initiatives like our Gift of Life project, which funds critical heart surgeries for children in need.
For more information on how Flat Planet can empower your business while making a positive impact, visit flatplanet.com.au or email us at info@flatplanet.com.
