How we ensure Medicare compliance

When compliance isn’t met, we escalate activities accordingly, however, our focus is primarily on early intervention and prevention.

  • Education and support
    Browse our range of education resources that support best practice in billing.
  • Targeted letter campaigns
    Learn how our targeted letters help you self-review your claims, find potential errors, and voluntarily repay any accrued debt.
  • Practitioner reviews
    Discover how we find and look at variations which may indicate possible inappropriate practice.
  • Audits
    Learn how we audit healthcare providers to ensure that all Medicare benefits paid to them comply with the requirements needed to receive them.
  • Fraud investigations
    Learn when and how we perform fraud investigations regarding Medicare compliance by healthcare providers.
  • Behavioural insights and interventions
    We use interventions informed by behavioural theories to encourage health providers to reflect on their billing practices and to improve compliance.
  • Data matching
    We data match to improve the detection of incorrect claiming, possible inappropriate practice and fraud.
Last updated: 
26 July 2021

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