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The original was posted on /r/maliciouscompliance by /u/Heartwerk2000 on 2024-07-16 09:47:47+00:00.

Throwaway because I intend to use this account for more healthcare stories and if any of my colleagues are Redditors I don’t want them to see the idiot arguments I get into with other idiot Redditors in my history.

So I’m a receptionist at a bulk billing radiology practice. Radiology practices are where you get X-rays, CTs, ultrasounds, MRIs, and other associated medical scans done.

“Bulk billing”, in my country, means that the scan is charged to Medicare, meaning the patient pays nothing. The great majority of our scans are bulk billed. There’s only a few bulk billing practices left because Medicare funding increases by a couple of bucks every year, and inflation… does not. Most of them have now gone private, but we still exist! I have no idea how!

Most of the scans that aren’t bulk billed are, flat out, scans Medicare won’t pay a cent for. (The exception is pregnancy scans where they pay a fucking fraction of what they pay for other ultrasounds, because the government desperately wants us all to have babies but not enough to actually do fuck all to make sure people have the money to do so.) For example, if a physiotherapist refers you, Medicare will only cover it if it’s a one or two region spine or a pelvis - and only if they’re X-rays. (Meanwhile, a doctor can write a referral for any part of the body and 99% of the time we bulk bill it. This will be important later.)

This is a bit baffling because to my knowledge, physiotherapists mostly work with muscles… pathologies of which are diagnosed with ultrasound, not X-ray. Medicare doesn’t cover physiotherapist-referred ultrasound. They just randomly got lumped in with their mortal enemies, chiropractors, when some random person set the standards for Medicare rebates. Physiotherapists will also often have someone come in with a sports injury and be like “hey, I’m not sure this is muscular, I think this might be an actual break” and write a referral for, say, a hand xray.

Now, full disclosure: physiotherapists are the bane of my life for unrelated reasons. But as you’re about to see, this just costs the government more in the long run.

So. Every now and then we get patients coming in for that hand xray, and a physio wrote it. If Medicare paid for it, it’d be $40-$50, split between twenty million taxpayers.

But… oh no! I’m so sorry! Medicare won’t pay for it because it’s a physiotherapist referral!

So why don’t you hop right next door to the walk in bulk billing GP, who can rewrite your referral to Medicare standards, thereby costing Medicare $40 for your GP appointment and THEN the $40-$50 for the xray, and we’ll just CC your physio in for the report? :))))