Community Based Pathology Billing
This information is to outline the outpatient/community based billing process through Laverty Pathology and should answer most of your questions. Should you have any further queries, please contact our Accounts Department on (02) 9005 7055.
Will I receive an account?
If you are a Pensioner or the holder of a current Health Care Card you are eligible to be bulk billed. If you are bulk billed you will not receive an account from Laverty Pathology for Medicare rebatable tests, your account will be billed directly to Medicare. If you are the holder of a Veteran Affairs Gold card your account will be billed directly to the Department of Veteran Affairs.
If your pathology request relates to Workers Compensation claim or a pre-employment or insurance medical your account can be forwarded directly to the employer or insurance company if relevant details are provided.
If you do not hold the concession cards mentioned you will be privately billed. If you are privately billed you will receive an account.
If I am privately billed what out of pocket expenses will I incur?
Private account charges for pathology are based on the Australian Medical Association rates. This means the fee includes the Medicare rebate amount plus a gap payment incurred as out of pocket expenses.
Laverty Pathology has a gap protection policy, which means after claiming from Medicare the maximum out of pocket expense will be no more than $195.00 per referral, for Medicare rebated tests performed by Laverty Pathology.
Does Medicare rebate all Pathology tests?
No, some tests are not eligible for a Medicare rebate. These include:
Thinprep, FISH, Ambulatory Blood Pressure Monitoring, Carbohydrate Deficient Transferrin, Contine, Nucleic Acid Amplification, Haemochromotosis as well as Quantiferon, Factor V Leiden, Brain Natriuretic Peptide and HPV testing which does not meet the Medicare criteria.
If you are having one of these tests and would like to know the out of pocket expenses, the staff at our Collection Centres will be able to advise you of the associated costs.
For details on how to pay your accounts please refer to the information provided on the back of your invoice.
Hospital In-patient Pathology Billing
This information is to outline the in-patient hospital billing process through Laverty Pathology and should answer most of your questions. Should you have any further queries, please contact our Accounts Department on (02) 9005 7055.
Will I receive an account?
Patients with Private Health Insurance
We have agreements with a number of private health funds including:
- Australian Health Service Alliance Funds
These agreements allow for those health funds to be billed directly for your pathology services whilst you are a private patient in a public or private hospital. You will not receive an account from Laverty Pathology and you will not incur out of pocket expenses for Medicare rebated tests performed by Laverty Pathology.
If you have private health insurance, but are not a member of any of the health funds listed, you will receive an account. You are eligible to receive a reimbursement from Medicare and your Private Health Care Fund.
Patients without Private Health Insurance
If you are a patient without private health insurance and are not the holder of a Pension card or current Health Care Card you will receive an account. You will be able to claim 75% of the scheduled fee through Medicare. You will be required to pay the balance.
Pension and Health Care Card holders without Private Health Insurance
If you are the holder of a Pension or current Health Care Card and do not have private health insurance you will receive an account charged at the Medicare Schedule Fee. Of the fee, 75% will be reimbursed through Medicare and you will be required to pay the balance.
Veteran Affairs Gold Card holders
If you are the holder of Veteran Affairs Gold card your account will be billed directly to the Department of Veteran Affairs for payment. You will not incur out of pocket expenses.
If your pathology relates to a WorkCover claim, your account will be sent directly to this organisation.