🇦🇺Australia

MBS Billing Non-Compliance Fines

1 verified sources

Definition

Refraction billing uses MBS items (e.g., 109xx series); failure to meet education, registration, or item rules leads to Services Australia audits.

Key Findings

  • Financial Impact: AUD 2,210+ per incorrect MBS claim; AUD 10,000+ audit penalties
  • Frequency: Per audit (1-2/year high-risk practices)
  • Root Cause: Manual verification of provider eligibility and item restrictions

Why This Matters

The Pitch: Optometry practices risk AUD 5,000+ fines per MBS audit failure. Automated MBS item validation prevents overbilling penalties.

Affected Stakeholders

Practice managers, Optometrists

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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

Incorrect GST Billing on Exempt Items

AUD 50-200 per rejected claim; 10-20 claims/year per practice

Unbilled DVA Restrictions Violations

AUD 100-500 per denied lens/consumables claim

Nicht abgerechnete Kontaktlinsen-Anpassungen und Nachsorge

Quantified: ca. AUD 14.000–28.000 Umsatzverlust pro Praxis und Jahr (1–2 unbezahlte Kontaktlinsen-Konsultationen pro Werktag à ~AUD 60).

Umsatzverlust durch vergriffene Kontaktlinsen-Testlinsen

Quantified: ca. 2–5 % des Kontaktlinsenumsatzes; bei AUD 300.000 CL-Umsatz ≈ AUD 6.000–15.000 entgangener Umsatz pro Jahr durch Stock-outs von Trial- und Standardlinsen.

Überbestände und ablaufende Kontaktlinsenbestände im Lager

Quantified: typischerweise 5–10 % Lagerabschreibung auf Kontaktlinsenbestände; bei AUD 30.000 Lagerwert ≈ AUD 1.500–3.000 direkte Kosten pro Jahr, exklusive Kapitalkosten der Überbestände.

Kundenabwanderung durch langsame Kontaktlinsenbestellung und -abwicklung

Quantified: ca. 5–15 % Kundenabwanderung von Kontaktlinsenpatienten; bei AUD 300.000 CL-Umsatz ≈ AUD 15.000–45.000 entgangener Jahresumsatz.

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