29 Apr The Essential Numbers For Setting Up A Medical Practice
Setting up a new medical practice requires considerable planning, time, and often financial investment. It is critical to plan ahead, not just on the physical aspects of the medical practice such as the location, building fit out and personnel, but also the administrative aspects.
Obtaining an ABN
An Australian Business Number, or ABN, is a single business identifier number that allows businesses to deal with the Federal Government. All practitioners need an ABN if they are interested in claiming GST credits on costs incurred in their practice. An ABN can be obtained online from the Australian Business Register’s website here: www.abr.gov.au
Registration with the Medical Practitioner Board
Prior to commencing practice, doctors are required by law to register with the Medical Practitioner Board. For more information, please visit www.medicalboard.gov.au.
How to apply for registration
The Medical Board ensures doctors are fit to practice medicine according to the Australian medical standards. They set practicing guidelines, and investigate any complaints made against doctors.
Each state and territory has a separate governing medical board. Each board is responsible for making registration and notification decisions about individual medical practitioners.
National registration came into effect on 1 July 2010. Medical practitioners with general registration can practise in any state or territory in Australia.
Types of registration
The Medical Board has provided the following guidance regarding the various types of registrations.
Australian or New Zealand medical school graduates, who have completed an approved inter training; medical practitioners who have previously held general registration and are seeking to return to practise; international medical graduates who have completed the requirements of the competent authority pathway or the standard pathway should peruse the general registration form for medical practitioners, which is available here: Medical Board Application.
Medical practitioners with general registration can practise in any state or territory in Australia.
Australian or New Zealand medical school graduates, who wish to undertake an accredited internship position, should peruse the provisional registration form for medical practitioners, which is available here: Australian and New Zealand medical graduates.
Australian Medical Council (AMC) certificate holders, are eligible to apply for provisional registration so they can undertake a 12-month period of approved supervised practice to meet the requirements for general registration. They should peruse the provisional registration for AMC , which is available here: Australian Medical Council Certificate.
Provisional registrants nearing completion of their internship are encouraged to apply for general registration early to ensure a timely application process. This can be done online here: Transition from Provisional to General Registration for Medical Interns
Specialist registration is available to medical practitioners who have been assessed by an AMC accredited specialist college as being eligible for fellowship. Fellowship is not a pre- requisite for specialist registration.
The Ministerial Council has approved a list of specialties, fields of specialty practice and specialist titles. Medical practitioners with the necessary qualifications in the approved specialties will be included on the Specialist Register and their specialist title will be protected by law.
For more information please visit Specialist Registration.
Limited registration is available to medical practitioners whose medical qualifications are from a medical school outside of Australia or New Zealand.
These medical schools must be listed in the ‘Australian Medical Council recognised medical schools’ and the World Directory of Medical Schools. Approved courses of study means that the applicant must be able to demonstrate that they have completed a medical curriculum of at least four academic years, leading to an entitlement to registration in the country issuing the degree to practise clinical medicine.
The types of limited registration are:
- Postgraduate training or supervised practice
- Area of Need
- Public interest
- Teaching or research
For more information please visit Limited Registration.
This type of registration may be suitable for medical practitioners who:
- have retired completely from medical practice,
- are having a temporary absence from practise (e.g. on maternity or paternity leave) or
- who are not practising in Australia but are practising overseas.
Non-practising practitioners seeking to prescribe and/or refer to other health practitioners may apply for general or specialist registration and will need to meet the Board’s registration standards for:
- continuing professional development
- recency of practice
- professional indemnity insurance arrangements
- criminal history
For more information please visit Non-Practising Registration.
The registration fees are set out at: Schedule of fees
Registration for medical practitioners with general, specialist or non-practising registrations must be renewed annually by 30 September, and those with limited or provisional registrations are determined on a case by case basis.
Ensuring registration is current is the responsibility of the doctor. If the Board does not receive the renewal fee by 30 September or within the one month late period, names will be removed from the national register and registration will lapse.
Professional Indemnity Insurance
A registered medical practitioner needs to be covered by professional indemnity insurance. The insurance is subject to the area of practice that the practitioner is involved in during the registration period, with a minimum of $5 million or whatever greater amount is prescribed from time to time for the purposes of section 16 of the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003.
Medical practitioners who are unable to obtain indemnity insurance should approach the Board for consideration of their medical registration.
Further information can be obtained from: Medical Board – Registration Standards.
Registering with Medicare
Every practitioner must have at least one Medicare provider number. A different provider number is issued for each practice location and the relevant provider number must be included on all accounts, stationery, referrals, pathology and radiology requests, and similar documents.
Provider numbers can be applied for through Medicare Australia Provider numbers. Applying for a provider number is the first step in ensuring the doctor can provide medical services for patients. It also ensures doctors get paid the correct amount for those services. It is important to be aware that under some circumstances Medicare provider numbers may expire without any reminder notices. This expiry will depend on the eligibility to provide services, and whether there are any restrictions associated with the initial provider number. Ample time should be allowed for initial registration and renewal, to ensure that doctors are adequately registered at all times.
The Medicare website has very useful tools allowing doctors to keep track of their registrations, be up to date with new regulations, and access various registration forms. It can be accessed at: Medicare Australia – Provider. The registration form for each medical practitioner will vary according to the nature of the service provided. The following table summarises the different requirements for various medical practitioners.
|General Practitioners||Must ensure that each General Practitioner has a separate Medicare Provider number for each location from which they provide services.|
|Optometrist||Registration for optometrist professionals. Additional supporting documentations may be required to be attached to the application form.|
|Dentist/ Dentist specialist/ Dental Prosthetist||Registration form for dental professionals. Additional supporting documentations may be required to be attached to the application form.|
|Vocational Registration||Practitioners who are certified and included on the Vocational Register of General Practitioner have access to certain items on the Medicare Benefits Schedule (MBS).|
To be included on the register, you must have certification by the Royal Australian College of General Practitioners (RACGP) or the General Practice Recognition Eligibility Committee (GPREC).
|Locum Doctor||Locum doctors must use a separate provider number for each location that has been allocated to them. Medicare benefits cannot be claimed unless that doctor’s provide number appears on all relevant documents. This must be done even if the locum doctor provides services for a very short period of time. Under no circumstances can a locum doctor use another doctor’s Medicare Provider Number.|
Locums can request for their Medicare benefits to be deposited directly to the principal of the practice or the employer. A ‘pay group link’ can be set up to redirect these payments. Bulk bill stationery allows the providing practitioner to direct the Medicare benefits to another health professional.
It is the responsibility of the practice owner to ensure that locum staff only use a provider number allocated to them, not the number of the doctor they are filling in for.
|The ‘pay group link’ application form can be downloaded here:|
|OMP Program||The Other Medical Practitioners (OMP) programs are designed for non-vocationally recognised doctors who provide services in approved locations and meet other eligibility criteria specific to the program to be able to receive Medicare rebates.|
This program is designed for practitioners in rural areas, in districts of workforce shortage (DWS), in outer metropolitan areas, provision of afterhours services, or if the practitioner is a temporary resident doctor.
Registration in the program assumes doctors have expressed interest in undertaking an alternative pathway to vocational recognition.
|More information on OMPs is available here: Department of Health and Ageing – OMPs.|
|Pathology||Only an Approved Pathology Practitioner (APP) can claim Medicare benefits. It is possible to claim benefits on an APP’s behalf.|
To become an Approved Pathology Practitioner (APP), you will need to submit an application and also pay the prescribed fee.
|You can read more on APP here:|
Application form is available here:
Prescribing under the PBS
Obtaining a prescriber Number
Every practitioner also needs a prescriber number. This enables them to prescribe Pharmaceutical Benefits Scheme (PBS) medicines. This number must appear on all prescriptions and similar documents, and is the same for every location the doctor works from. This means that unlike a provider number, the prescriber number does not change with a change in location.
The PBS allows all Australian residents and eligible overseas visitors to purchase prescribed medicine in an affordable way. Through the PBS, the Australian Government subsidises the cost of prescription medicine, making it affordable.
There are restrictions on certain PBS medicines, and some may require approval from Medicare prior to doctors prescribing them. This could occur in cases where the doctor feels that the patient requires an increased number of repeats, or a quantity greater than the maximum amount listed in the Schedule of Pharmaceutical Benefits. Where there are restrictions prescribers will need to provide additional information. In these cases, doctors will need to contact Medicare Australia to obtain an authority approval each time they prescribe an authority required medicine, or when prescribing increased numbers of repeats, or large quantities of medicines.
As new medicines are marketed frequently, doctors can remain current by joining the mailing list of independent review of therapeutics, such as Australian Prescriber. More information can be accessed from Australian Prescriber.
Medicare Benefits Schedule Book
Medicare benefits are fees paid for professional services rendered by doctors, some dentists, optometrists and eligible allied health professionals. The benefits covered by Medicare are contained in the Medicare Benefits Schedule (MBS) which also provides notes to explain the Medicare program, and each part of the Schedule in detail. A copy of the Medicare Benefits Schedule can be obtained from: Department of Health and Ageing – Medicare Benefits Schedule. MBS online regularly updates information relating to item numbers that are amended or deleted and can be accessed at MBS online.
An overview of chronic disease management (CDM) item numbers and enhanced primary care (EPC) items numbers can be found at Integrated Chronic Disease Management. These allow practice nurses to assist GPs implement evidenced based models to increase positive patient outcomes.
Education sessions for medical practitioners
If thorough explanations on the Medicare Benefits Schedule, bulk bill processing, electronic claiming, private accounts, the Pharmaceutical Benefits Scheme and other MBS and PBS topics are needed, Medicare’s online education services’ eLearning offers an easy to use, interactive and free of charge flexible learning option. This is particularly useful for busy health professionals who can learn more at their own pace. Medicare’s eLearning can be accessed here: Medicare’s eLearning.
Medicare’s online education services also offers a wide range of other useful resources including quick reference guides, handbooks, Medicare news and bulletin board designed for health professionals.
Overseas trained doctors working in Australia can seek educational support via DoctorConnect provided by Australian Government Department of Health and Ageing. DoctorConnect can be accessed here: DoctorConnect