Data used in the letters

Page last updated: 15 August 2018

What data was used?

The Department’s concerns were identified in pathology services undertaken in 2017.

How was I compared to my peers?

The Department used peer comparison to target concerns regarding:

  • claiming the highest benefit item out of the group of similar pathology items; and
  • co-claiming MBS items not commonly claimed together.

These claiming comparisons involved:

  • pathology services rendered by all Pathologists as one specialty group
  • identifying your level of item claiming and where you rank amongst your peers for the same claiming.

Were hospital items excluded from the data?

Pathology services rendered in hospital were included in the compliance review, subject to the applicable pathology rules.

What considerations were taken into account in the data?

  • rejected claims were excluded
  • re-submitted claims were considered as one claim
  • self-determined services were low (<1%).