Clinpath Laboratories Billing Policy - Effective 1st November 2012
 

Clinpath Laboratories is a private pathology laboratory. The fees for pathology testing are separate from the fees charged by other treating doctors. 

All pathology tests incur a fee.  However, Clinpath Laboratories offers discounted fees to "concessional" patients.

 

Account Enquiries and Assistance

If you need assistance, please contact our Accounts department on (08) 8366 2066 between 9am and 3pm Monday to Friday.

Or email accounts@clinpath.com.au

 

Bulk-billing policy

 

If you fall into one of the following categories, your services will be bulk-billed.
(Medicare rebateable items only)

 
  • Holders of a current Health Care Card
Health Care Card
 
  • Holders of a current Pensioner Card
   pensioner Card
  • Holders of a current Veterans Affairs Card
   repat Card
  • Nursing home patients

 

  • Patients over 65 years of age

 

  • Patients under 17 years of age

 

 

 

 
Medicare Rebate Eligibility   
   

The following billing policy applies only to patients who are eligible for a Medicare rebate and for tests listed in the Medicare Benefits Schedule.

Your Medicare rebate is the subsidy provided by the Australian government for tests that are included in the Medicare Benefits Schedule. If any of your tests are not covered in this Schedule you will not receive a rebate. You will need to pay for these tests in full. For more information about personal and test eligibility visit the Medicare Australia website http://www.medicareaustralia.gov.au/ or contact Medicare on 132 011.  

 

Outpatient (Community Based) Pathology Services

Concessional patients (see above) will be bulk billed and will not receive an account from Clinpath Laboratories.

Non-concessional patients may be privately billed and receive an account from Clinpath Laboratories. Our fees are based on the AMA list of medical services and fees. When you have paid your account you can submit the receipt to Medicare to claim the Medicare rebate.


Out-of-pocket expenses for Medicare-eligible outpatient pathology tests

Out-of-pocket expenses are incurred when the private account from Clinpath Laboratories exceeds the sum of rebates payable by Medicare Australia and/or your private health insurance fund. When we issue a private account we limit our fees so that your out-of-pocket expenses are kept to a minimum.
The maximum out-of-pocket payment for Medicare
-eligible outpatient pathology tests performed on a single day, regardless of number or complexity of tests, is $120.



Inpatient (Hospital) Pathology Services


Inpatient pathology services refer to tests performed on:

  • A private patient in a private hospital or approved day hospital facility, or
  • A private patient in a recognised (public) hospital  


1. Inpatients who have eligible cover with a private health insurer.
 

Clinpath laboratories has a NO GAP agreement for hospital inpatients with certain health insurance funds.

If you have insurance cover with a private health fund that has a "No Gap" agreement with Clinpath, your account will be billed directly to Medicare Australia and your private health insurer for full payment. You will not incur any additional out-of-pocket expenses. Clinpath has "No Gap" agreements with the following health funds:

 

ANZ Manchester Unity
ACA Health Benefits Fund Medibank Private
Australian Health Management Mutual Community
Australian Union Health Navy Health Ltd
Australian Unity Health NRMA
BetterHealth Cover onemedifund
BUPA Peoplecare Health Insurance
CBH Friendly Society Phoenix Health
CUA Health Fund Police Health
Defence Health Queensland Country Health Fund
Druids Friendly Society (NSW) rtHealth
Grand United Health Rail & Transport Health
Health Care Insurance Reserve Bank Health Society Ltd
Healthguard Health Benefits St Lukes
Health Partners Teachers Federation Health (NSW)
HBF Teachers Union Health (QLD)
HCF The Doctors Health Fund
HHB Transport Health
HIF West Fund

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Any tests that are not covered under the Medicare Benefits Schedule will incur an additional fee that may not be covered by your private health insurance.  These tests must be paid for in full, and are not eligible for a Medicare rebate.  For more information about Medicare rebates, visit the Medicare Australia website www.medicareaustralia.gov.au.  Further information can also be provided by your private health insurer.

If you have eligible cover with a private health fund that does not have a "no gap" agreement with Clinpath, you will receive an account for your pathology tests.  You will be eligible for your Medicare rebate, and you can then present the paid account to your private health fund for a further rebate.  Any out-of-pocket fee will be capped to a maximum of $350 per admission.


2. Inpatients without eligible private health insurance.
 
If you do not have eligible private health insurance you will receive an account from Clinpath Laboratories.
Your pathology tests will be charged a maximum in accordance with the Australian Medical Association (AMA) schedule of fees. When the account is paid you can present the receipt to Medicare Australia to claim the rebate which will amount to 75% of the Medicare Schedule fee. The difference between our fee and the rebate is your out-of-pocket expense.


Out-of-Pocket Expenses for Medicare-eligible inpatient pathology tests.

Out-of-pocket expenses are incurred when the private account from Clinpath Laboratories exceeds the sum of rebates payable by Medicare Australia and/or your private health insurance fund. When we issue a private account we limit our fees so that your out-of-pocket expenses are kept to a minimum

Paying your Account

Australia Post Office.
The receipt you receive can be used to claim your Medicare rebate.
 
BPay Internet Banking. The reference number is unique; you will need to change this number for each new account. Your receipt will be mailed to you.
 
Phone - Credit Card 1300 138 202 -  24 hours, 7 days a week. Your receipt will be mailed to you.

 
Claiming your Rebate


When the account is paid, you will be forwarded a receipt to submit to Medicare to claim your rebate. Your Medicare rebate is the subsidy provided by the Australian government for services that are included in the Medicare Benefits Schedule. If any of your tests are not covered in this Schedule, you will not receive a rebate. You will need to pay for these tests in full. 


For more information about personal and test eligibility, visit the Medicare Australia website http://www.medicareaustralia.gov.au/ or contact Medicare on 132 011.