Following last night's ABC Four Corner exposè on the seemingly rampant overcharging and double-charging in the multi-billion-dollar pain industry - and being a forensic accountant from way back, albeit retired - I idly perused a seemingly minor tooth extraction I underwent in June 2022.
To my absolute horror and total surprise, the anaesthetist attending the surgery seemed to have charged both my Medicare card AND my private health insurer, Medibank Private, with exactly the same amount, to wit:
According to my Medicare claim history, four charges of $332.90 + $166.50 + $111.00 + $55.50 = $665.90 minus $250 excess, were lodged against Medicare, and the exact-same four claims also appear on my private health insurer's records, an apparent overcharge of $415.90.
(And guess what: the very same thing happened again on the occasion of my leg operation five months later in November. Is this a peculiarity in recording these charges or a 'double-dipping' by the 'Ether Bunny'?)
$111.00 + $332.90 + $166.50 + $55.50 = $665.90 minus $250 excess
I sent an email to the good doctor's office, "I reviewed my Medicare and Medibank Private claims, and it seems that the anaesthetics charges for my tooth extraction on 10 June 2022 have been duplicated to both Medicare and Medibank Private - see attachments. Please advise."
Their almost immediate reply was far from satisfactory, "Eclipse is an online system whereby your account is sent to both Medicare and your Private Health Fund. The payment is a combined Medicare/Medibank Private total", which prompted me to 'escalate' (as they say in the jargon) my inquiry by writing to both Medicare and Medibank Private.
As Medibank Private states on their Fraud Reporting webpage: "We know that making a report can feel a bit scary, but you’re doing the right thing for all of our members. If confidentiality is a concern, you don’t even need to give us your name. The more information you can give us, the more likely we’ll be able to do something to prevent further fraud."
Medicare isn't quite so forthcoming but they have a Feedback facility:
"Seeing these one-and-the-same charges on both my Medicare and MEDIBANK Private claims history is very confusing and I am unable to receive a satisfactory answer from the health professional hence my feedback to you. I hate to think that these claims have been DOUBLE-charged to both Medicare card AND my MEDIBANK Private insurance."
