A recent case involving a medical receptionist who stole close to $30,000 is a salient reminder for GPs to check their own billing history.
A Tasmanian medical receptionist has pleaded guilty to defrauding Medicare to the tune of almost $30,000 – but the crime was only detected by a GP reviewing patient consultation records.
Erin Grant, 36, pleaded guilty to 108 counts of computer-related fraud, and was sentenced to 12 months’ home detention.
She was also ordered to repay the $29,512.65 which she had obtained via fraudulent Medicare claims.
Beginning in August 2021, Grant entered false details into the practice software, claiming that patients had attended appointments and paid in cash. She then lodged these claims with Medicare, directing the rebates to her personal debit card.
She then cancelled the false appointments in the system to ensure that the practice financial records remained accurate.
She billed under the names of eight separate doctors, occasionally recording herself as the patient.
Grant’s deception was uncovered in April 2022, when one of the clinic doctors noted an irregularity in his patient consultation record.
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David Dahm, an accountant with special interest in primary care, encouraged GPs to initiate their own billings to help avoid situations like this.
Acknowledging that this was likely to be an unpopular idea, he also told The Medical Republic that more internal controls were a good deterrent.
“The person who raised the invoice [should] not the same person who actually authorises it,” Mr Dahm said.
“It should be an independent person – a practice manager, for argument’s sake – to approve all these … in the billing software program.
“Because if you’re not actually doing that, you’re not actually picking up these problems early in the piece. And if the internal controls aren’t in there, that creates the opportunity.”
After admitting to the offences, Grant told Tasmania Police that she had been diagnosed with dissociation disorder after the offences. She would later advise that she had no memory of committing the offences.
In his sentencing comments, Justice Stephen Estcourt said he considered Grant’s offending serious due to the breach of trust between employer and employee.
However, taking into account Grant’s personal circumstances at the time of offending, her remorse and her medical diagnoses, Justice Estcourt said he was of the opinion that home detention would be the appropriate sentencing outcome.
