Information for Medical Practitioners Effective December 2009
Pathology billing category determined by our referrers
- Our pathology billing category for Medicare rebatable tests is determined by our referring practitioners.
- Please clearly indicate on our request form your preferred pathology billing option – if there is no indication from you, we will default to private billing.
Pathology billing categories available at Clinipath Pathology
- Bulk Bill
- Rebate Account
- Department of Veterans Affairs (DVA)
- Private Account
- Our gap for private account patients ranges from $1 to a maximum of $50 per episode.
- Patients who receive private accounts may be covered by the Medicare Safety Net
We will bulk bill the following categories of patients
- All those patients you deem necessary
- Pensioners
- Healthcare Card Holders
- Department of Veterans Affairs Patients
- Children under 16 yrs
Non-rebatable tests
- Medicare Australia does not pay for a number of tests.
- Clinipath Pathology has set competitive fees for such tests
- Common Non-Medicare Rebatable Tests include –
ThinPrep - $35
HPV (for non Medicare eligible patients) - $100
Mantoux - $70
Inpatient pathology billing options
- Rebate
- Department of Veterans Affairs
- Private Accounts Categories
Three categories exist, depending upon whether the patient is a member of a health fund and whether their private health fund is affiliated with Clinipath Pathology and has a no gaps agreement.
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| | - Inpatient private accounts - affiliated private health funds
Clinipath Pathology has a 'no-gap' arrangement with a number of affiliated private health funds. The list of participated funds can be viewed via this link - Health fund agreements. To enable us to directly invoice on behalf of your patients we require both the private health fund and Medicare numbers.
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| | - Inpatient private accounts - non affiliated funds
These patients will receive a private account, part of which will be claimable from Medicare (75% of MBS) and part from their Health Fund (25%).
Medicare and the patients Health Fund payment may not cover the entire fee.
Our maximum gap for these accounts is $50.00 per episode.
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| | - Inpatient Uninsured Patients
These patients will receive a private account with a maximum gap payable of $50.00 per episode.
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Clinipath Pathology has no hidden surcharges
- No Account Processing Fee
- No Additional charges on top of Medicare rebates for ‘special tests’ – e.g. Triple and First Trimester Tests
- No location surcharges
- No additional charges for urgent call outs, after hours tests, home visits
- No additional charges for pathologist and senior scientist after hours urgent phone calls
Accounts information available for patients