Billing Information
The billing procedure for pathology testing is a complex process
that is dependant on a number of variables including whether the
test is fully rebatable by Medicare and whether it needs to be
referred to another laboratory. We aim to be fair and reasonable
with our fee structure. Fees are set as low as possible within the
bounds of providing a high quality, comprehensive pathology
service. You should be aware that you may be charged an
out-of-pocket fee depending on the tests your doctor has ordered
for you. Fees fall into three main categories:
1. Standard fee
Patients will be charged a fee that is based
on the number and complexity of tests ordered on each referral
(known as an episode). A significant portion of this fee is
rebatable under Medicare, however there may be an out-of-pocket
expense which the patient is liable to pay. St John of
God Pathology is committed to keeping this fee as low as
possible. Please note that some tests are not covered under the
Medicare schedule, and these non-rebatable tests will be charged as
an additional fee.
2. Direct bill Medicare for rebatable tests
St John of God Pathology will directly bill
Medicare for all pensioners, Health Care cardholders and in other
exceptional circumstances. We will also directly bill the
Department of Veterans’ Affairs for all Veterans’ Affairs gold
cardholders. If your pathology relates to a WorkCover or Motor
Vehicle Insurance claim, or to a pre-employment or insurance
request, your account will be sent directly to
those organisations. If your tests include any that are
non-rebatable, you will be issued a single invoice for both your
rebatable and non-rebatable tests. Please note that the rebatable
portion of your tests is fully refundable by Medicare.
3. Hospital inpatients
During your stay in hospital your doctor may
order pathology tests to assist in your treatment and recovery.
Please note that in some cases, tests may be sent to a reference
laboratory who may issue an individual account.
Frequently asked questions about billing
1. Will my private health insurance cover the full cost
of pathology tests whilst I am in hospital?
No, both the Medicare and health fund benefits
payable have not kept pace with the actual cost of providing
pathology services, creating a gap between the fees charged and the
benefits paid by both Medicare and private health insurance
funds.
2. Will I get a bill from Pathology?
Yes, you will receive a separate invoice for
pathology services performed by St John of God Pathology.
3. What sort of out-of-pocket expense can I expect in my
pathology bill?
The total fee for pathology testing during
your stay will vary depending on the frequency, volume and
complexity of pathology tests requested by your doctor during your
hospitalisation. For these reasons it is very difficult to estimate
in advance your ‘out-of-pocket’ expenses.
4. Department of Veterans Affairs (DVA)
patients
DVA patients will incur no ‘out-of-pocket’
pathology expenses whilst in hospital as there are federal
government funding arrangements in place.