Pandemic practicalities webinar

Remaining participants’ questions answered

Live webinar held on 8 April 2020
You can watch the webinar’s recording here.


 Telehealth 

Yes, there are specific MBS items for telephone consults and the MBS states: “A service may only be provided by telehealth where it is safe and clinically appropriate to do so”. If vision of the patient is clinically indicated, revert to a video consultation or face to face consultation. See telehealth FAQs.

Personal mobile devices should not be used to record video consultations. We also recommend you block your number if using your personal phone. Any images relating to patient care need to be added to the patient record and then deleted from your device.

See this Clinical images and the use of personal mobile devices guide (MIIAA & AMA) for further information.

Yes. Document the presence of other parties and the patient’s consent for their involvement.
See telehealth toolkit.

The usual MBS requirements apply for billing and documentation. It is useful to note the time taken for the consult (start and finish times not necessary).

Yes. Patients do not need to be a practice patient or have been seen in the last twelve months. See telehealth FAQs.

Relevant changes were made on 20 April 2020. See telehealth FAQs.

Yes. See telehealth FAQs.

Yes. See telehealth FAQ.

Not all consultations can be done via telehealth. The MBS states, “A service may only be provided by telehealth where it is safe and clinically appropriate to do so”. It will be a clinical decision as to whether a face to face consultation to conduct an examination should be arranged.

The Department of Health (DoH) have advised that referral to available face to face services should occur as appropriate.


 Billings 

Yes. See MBS Online COVID-19 Temporary MBS Telehealth Services GPs and OMPs items fact sheet.

Note: the requirements of the Chronic Disease Management items are as per usual e.g. 721, 723, 732.

If you are a non-GP specialist, you can charge a gap. General practitioners must continue to bulk bill patients under 16 years of age. See telehealth FAQs.

Yes. See the MBS Online COVID-19 Temporary MBS Telehealth Services Specialists fact sheet for the video and phone equivalent item numbers.

Yes. See telehealth FAQs.

1. See Provider Frequently Asked Questions, MBS Online: “Where the subsequent attendance on the same day does constitute a continuation of an earlier attendance, the sessions are regarded as being part of a single attendance for benefit purposes” (p5).

And see MBS Note AN.0.7.

2. This depends on whether each consultation is considered a “full service”. See MBS Provider Frequently Asked Questions.


 Employment 

You may be asked to work in area that is not your specialty, please see the Medical Board of Australia’s “Guidance scope of practice – doctors with general and specialist registration” (scroll down to the text box in this link).

Also see Membership and insurance FAQ, “What if I am asked to work outside my usual specialty or area of practice?”

This is a practice issue but doctors should not be working without the appropriate PPE.

See Membership and insurance FAQ, What if I am asked to work outside my usual specialty or area of practice to help with the effort to manage COVID-19? See part b. Standard of care.

This would need to be discussed and agreed between the practice management and doctors.


 Practice/staff 

It will be a clinical decision as to whether an illness or injury requires immediate action. Treatment of patients in emergencies is covered in the Code of Conduct in that in addition to the patient’s best care, doctors should take “… account of their own safety, skills, the availability of other options and the impact on any other patients under their care …”(p7).

This is a clinical and workplace issue, and see practice related FAQs.

This is a clinical and workplace issue, and see practice related FAQs.

Need to seek independent legal, accounting or workplace advice, and see practice related FAQs.

Need to seek independent legal, accounting or workplace advice, and see practice related FAQs.

Need to seek independent legal, accounting or workplace advice, and see practice related FAQs.

Seek advice from local public health unit (PHU).


 Other 

See federal Department of Health website for up to date information for health professionals. Also see patient FAQ, “My patient has asked me for a certificate …”

See patient FAQ, “My patient has asked me for a certificate …”
See patient FAQ, “My patient has asked me for a certificate …”

Generally yes, if the previous referral was for the usual 12 months – see MBS Note GN.6.16.

See above and: if the referrer is providing telehealth then it is possible to receive an electronic version; however, the original referral does need to be signed by the referrer and sent to the receiving specialist.

Any complaint or claim which may arise from an alleged delay in diagnosis or treatment will be judged in the context of the environment and government recommendations that were in place at the time.
The Medical Board has indicated it will take account of extraordinary circumstances in which you are working and heavy demands being made of you.

Not on its own. If both the doctor/practice and patient agree that physical attendance is necessary and/or acceptable, a face to face consultation can be arranged. If the patient meets the “vulnerable” criteria then a telehealth attendance in the first instance may be preferable.

Attempt to speak with someone else in the patient’s home to encourage an ambulance call, explain urgency, and what may happen if the person does not attend hospital and get medical care – do the best you can. A competent person cannot be forced to go to hospital. Document very clearly your advice and their response.

 

This Q&A is generic information only and does not take into account the physical state, medical status and/or health requirements of any particular individual which are relevant to proper diagnosis and treatment of any problem, condition or disorder, nor does the information take into account the particular facts relevant to any legal, financial or workplace issue. MDA National Members need to contact us for specific advice. We may also refer you to other professional services. The opinions expressed by any health professional on this website are those of the relevant health professional and not the MDA National Group.