🇦🇺Australia

Unbilled MHTP Sessions

2 verified sources

Definition

After initial 6 allied health sessions, GP review is mandatory for further claims up to annual maximum. Missed reviews due to poor goal tracking result in lost revenue from unbilled sessions.

Key Findings

  • Financial Impact: AUD 180-300 per psychologist session (MBS rebate); AUD 1,800+ per patient for 10 missed sessions
  • Frequency: Every 6 sessions or calendar year reset
  • Root Cause: Manual tracking of patient progress against undocumented or non-measurable goals

Why This Matters

The Pitch: Mental Health Care players in Australia 🇦🇺 waste AUD 1,800 per patient annually on unclaimed sessions beyond initial 6. Automation of review scheduling and goal tracking captures full Medicare rebates.

Affected Stakeholders

GPs, Allied Health Referrers, Billing Staff

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Financial Impact

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Current Workarounds

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Methodology & Sources

Data collected via OSINT from regulatory filings, industry audits, and verified case studies.

Evidence Sources:

Related Business Risks

MHTP Review Delays

2-4 weeks delay per review = AUD 65.30 lost per delayed review claim + AUD 1,000+ admin time (10 hours @ AUD 100/hr)

Verzögerter Zahlungseingang durch überstrenge oder uneinheitliche Einwilligungsprozesse

Quantified: For a mental health/AOD provider billing AUD 3 million annually, overly restrictive and manual consent/disclosure processes can extend DSO by 10–20 days, immobilising roughly 5–15% of revenue as extra working capital (≈AUD 150,000–450,000 locked in receivables) and generating additional admin labour of 20–40 hours per month in chasing missing consents and resubmitting claims.

Fair Work Act Penalty Failures

AUD 756+ per STP failure (unit penalty); AUD 11,500+ SG charge per employee annually at 11.5% rate

Coordination Bottlenecks in Stepped Care

20-40 hours/month per coordinator in manual delays; 10-20% capacity loss

Überhöhte Verwaltungskosten im Schadensprozess für psychische Erkrankungen

Logic-based estimate: ≈250–700 non-billable staff hours/year on complex mental health-related claims support per mid-sized service (≈AUD 15,000–40,000/year at AUD 60/hour).

Fair Work Act Penalty Units for Non-Compliance

AUD 63,000 per serious contravention (945 penalty units x AUD 66.60/unit from July 2024); SG Charge up to 200% of shortfall; typical SME: AUD 5,000-20,000/year in penalties[1][2]

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