Item 732 reviews: the underclaimed half of GPMP revenue every clinic forgets

Here's the maths most clinics never run. For every GPMP you bill (item 721, $164.35), Services Australia expects two reviews per year (item 732, $82.20 each). One GPMP should generate $328.75 of annual claims — the initial plan plus two reviews.

The national average is around $190. Almost half the recurring revenue inside the GPMP system is being left on the table.

Why reviews get missed

Three reasons, in order of how often we see them:

• Nobody's tracking which patients are due. The recall list lives in the practice manager's spreadsheet and gets touched twice a year, not weekly.
• The review consult itself isn't billed as 732 because the clinician forgets to flag it as a care-plan review. The 23 standard consult code gets used instead — same time, half the rebate.
• Patients don't know they have a plan to review. They book in for a 'check-up' and leave without the documentation being touched.

What a working recall system looks like

Every active GPMP has a next-review date. The system should: (a) surface it to the patient in their app at 6 weeks out, (b) prompt the clinician at the start of the consult, (c) auto-flag the 732 claim code at sign-off. None of that is hard. It just has to happen by default, not by memory.

The 6-month-mark conversation

A 732 review isn't a re-write. The legislation defines it as 'reviewing the management plan with the patient' — that's it. Same plan, refreshed goals, signed off. 10 minutes of consult time, $82.20 of rebate.

Once we wired automatic 732 flagging into our practice's workflow, our review claim rate moved from 31% to 78% in a quarter. Same patients. Same plans. The difference was the system noticing on our behalf.