ManageBGL in a Tele-Health/Telemedicine Environment
ManageBGL is an enabling technology for tele-health
consultations, allowing a patient's complete logbook and charts to be accessible
online for simultaneous view by both patient, consulting doctor and General
Practitioners. Skype is also commonly encouraged by government for use in these
kinds of consultations.
In an Australian context, for a registered medical practitioner or specialist
to bill for a remote consultation:
The patient must not be a hospital admitted patient or
patient of an emergency department; and
The patient must be located in a telehealth eligible
(remote) area at the time of the attendance (see map below); and
The patient must be located at least 15km by road from
the patient can be a care recipient of a
residential aged care facility (located anywhere in Australia); OR
the patient can be a patient of an eligible
Aboriginal Medical Service (located anywhere in Australia).
Fifty-five existing specialist items, previously used only for
face-to-face consultations, can be used to provide services to patients via
video conference. These items must be claimed with one of 11 new ‘derived’
items, especially created for telehealth in order for the service to be
provided by video, rather than in person. The schedule fee for the new
'derived' items is 50% of the schedule fee paid on top of the schedule fee
for the service if provided face to face.
On 1 January 2013, 6 new MBS items took effect. These items provide for a
short initial video consultation where the consultation is 10 minutes or
less of direct face to face time with the patient (not including the time to
set up for the video consultation).
Defined remote areas are pretty much anywhere outside of Melbourne, Sydney,
Canberra, Brisbane, Adelaide and Perth. See the map below.
There are also billable items for 'patient-end services' when a GP provides
face-to-face clinical support to patients during their video consultation with
the specialist, where it's necessary for the provision of the specialist
patient-end service is necessary for the provision of the specialist
physically located with the patient in a telehealth eligible area; and
located at least 15kms by direct road from the specialist; and
Medicare eligible specialist serviceis
post-operative care is not a separately claimable service therefore a
patient – end service can’t be claimed); and
entire service is rendered in Australia; and
number matches the location of the service; and
patient is not admitted to hospital (including hospital in the home) or
located in an emergency department.
If any of these requirements are not met, such as if a specialist does not
submit a claim to Department of Human Services for the service, then the
Department of Human Services will seek recovery of the MBS rebate and
incentives for the patient-end service.
Can I use electronic claiming to
lodge a bulk bill claim?
You can use electronic claiming if you have those services available. Once
you have consent from the patient to assign the benefit to you, you should
lodge the bulk bill claim directly to Medicare on behalf of the patient. A
copy of the signed assignment of benefit form must be forwarded to the
patient for their records.
How do I write a prescription for
the patient if I’m not co-located?
Patient-end practitioners can provide prescriptions ordered by specialists
during a video consultation. If the drug to be prescribed can only be
ordered by an eligible specialist, consultant physician or psychiatrist, or
if a patient-end practitioner is not involved in the video consultation, the
specialist, consultant physician or psychiatrist can mail a prescription to
the patient or the patient's pharmacist.
Can a specialist order tests for
a remote patient?
Yes. There is no difference between a video and face-to-face consultation in
terms of ordering pathology and diagnostic imaging tests. In practice the
arrangements for these tests could vary between email, fax, mail and/or in
consultation with the supporting practitioner.