Frequently asked questions around accounts and billing
Below you will find some questions our receptionists often get regarding billing, accounts, and fees. Please click a tab to find information and our policy regarding different billing types and issues. If you feel your accounts query is not answered here, or If you would like more information about anything mentioned here, please call our offices and we will try to assist you and answer your questions as best we can.
The vast majority of patients receive MBS Pathology services with no out of pocket charge. The Medicare Assignment permits us to charge Medicare for requested pathology services on the patient’s behalf. This process has been put in place to ensure efficient management of billing and does not leave the patient out of pocket.
In line with Medicare policy and the Health Insurance Act 1973 the Pathologist conducts any requested pathology services as well as any eligible determinable service(s) he/she establishes as necessary. Most testing is covered by an appropriate Medicare Item Number, as at time of procedure, under the active version of the MBS, however some types of supplementary testing necessary for diagnosis are not covered.
As a general rule, where possible we will Bulk Bill Medicare sanctioned items. Sometimes Medicare will reject one of our claims due to any number of reasons (such as mismatched or incorrect patient details). If you have been issued a bill and hold a Medicare card, please call us to ensure we have your current details on file.
Metropath has the capacity to claim direct through some private health funds. Every private health fund has a different policy on what and how much the cover.
If you have private health insurance, and have received an invoice from us, please take your invoice to your health insurance fund and they may cover some or all of the account. Please consult your private health insurance fund for more details.
All patients holding a valid Veteran Affairs card will be billed through the Department of Veteran Affairs. Please note, we have found that sometimes other clinic’s practice software does not print the Vet Affairs card number on the paperwork we receive. If you have received a bill from us and hold a Veteran Affairs card, please ring us as we may be unaware you have one.
In cases where extra services are required for diagnostic purposes, a bill may be issued for non Medicare rebateable items. If you have received a bill from us, it is likely to be for services we cannot bill direct to Medicare for. In these cases, different private health insurance companies have varying policies on giving rebates for such services. You should enquire with your health fund what your policy covers.
One common non Medicare billable item is Thinprep testing, which is taken alongside or instead of a conventional pap smear. Thinpreps provide a more detailed cytological image than Pap Smears, and so many GP’s recommend their usage. The fee for this testing is currently $36.00 AUD (as at Nov 2015). This cost would have been indicated to you at the time the sample was taken. If you have any questions about Thinpreps, Pap Smears, or other cytological issues, you may call our offices to be put in touch with a Cytologist, or contact your regular doctor.
Immunohistochemistry (or IHC) is extra testing for the presence of proteins in tissue samples. This information is used by pathologists to determine a diagnosis. Is it ordered on a case by case basis, and the majority of patients will not receive a bill for this. However, in some instances, a large panel of IHC is required in order for the Pathologist to effectively and correctly diagnose the condition. Medicare covers 4 stains per case. If the pathologist deems that more than four stains are required to make a diagnosis an invoice may be issued to cover the costs of performing the IHC.
For overseas patients with traveller’s health insurance or overseas student health insurance, you must submit your invoice to your fund directly. Either the health fund will pay Metropath directly or will ask the patient to cover the invoice and then will refund to your nominated account. If the fund partially covers the invoice, you will be required to cover the balance.
Patients that do not hold a valid Medicare Card will be charged at the 100% MBS rate for pathology services.
Please note, we have Vietnamese and Arabic speakers in our office. If you would like to speak to a multilingual staff member, could you please indicate as best you can to the receptionist.
As most patients are covered by Medicare and/or PHI schemes, a very small number of patients will receive invoices from Metropath. In most cases, a personalised invoice and accompanying explanatory statement will be posted out to the patient.
If you have received an invoice and are unsure of what the charges are for, or have questions regarding your invoice, please don’t hesitate to contact our offices on 03 9421 1399.
We accept payment via credit card (Visa and Mastercard) in person or over the phone. Alternatively, you can send us a cheque / money order along with the bottom slip on your invoice. If you would like to pay via a direct bank transfer, please ring us and a receptionist will provide you with the necessary information