Pathology billing determined by our referrers

Please clearly indicate the preferred billing option on our request form.

if there is no indication on the form, we will default to private billing.   


We will bulk bill the following patients*

  • Pensioners
  • Healthcare Card Holders
  • Department of Veterans Affairs
  • Children under 16 yrs
  • Those patients you deem necessary

 * There are some tests where Medicare does not cover either the full cost, or any of the costs of testing. In these cases, a portion of the fee is payable by the patient.


Medicare guidelines 

Medicare is the government health insurer and does not cover all of the costs of health care.  Medicare does not cover the costs of all pathology tessting.  In these cases, patients will incur an out-of-pocket expense.  A comprehensive list of medicare rebate criteria is available.  For current pricing on these tests, please contact Accounts on 9371 4460.

Tests where Medicare does not cover some or all of the costs of testing will have all, or part of the fee, payable by the patient.


Inpatient Pathology Billing

Affiliated private health funds

Clinipath Pathology has a 'no-gap' arrangement with a number of affiliated private health funds. The participating funds can be viewed here Health fund agreements. To directly invoice your patients, we require both health fund and Medicare numbers.


Non-affiliated health funds

  • These patients will receive a private account, part of which is claimable from Medicare, and part from their Health Fund.
  • Medicare and/or the Health Fund may not cover the entire fee. In these cases, our maximum gap for these accounts is $450 per hospital stay.

 

Uninsured Inpatients

These patients will receive a private account, with a maximum gap of $450 per hospital stay.

 

Information correct at May 2017.