Patient billing information
ACT Pathology is a public laboratory that provides services to both public and private patients.
Under our "No-Gap" Billing Policy, we bill through Medicare, Veterans Affairs and the private health insurance funds so that patients do not have to pay a gap for their pathology testing.
We require a patient's Medicare number and signature in the assignment box on the request form to bulk-bill eligible outpatient services. Patients who do not complete the assignment box will be issued an account that must be presented to Medicare to receive a full refund.
Private Inpatients and Day Stay Patients
ACT Pathology has arranged simplified billing agreements with most health funds. We can send pathology accounts directly to the health fund if we are provided with the patient's Medicare number, health fund name and membership number on the request form.
If these details are not provided the patient will be issued an invoice. The patient must present this invoice to their health fund and Medicare to receive a refund.
Tests not performed by ACT Pathology
There are some specialised tests that are not performed by ACT Pathology. These tests are referred to highly regarded laboratories in other states and occasionally to overseas laboratories.
Generally, our chosen reference laboratories bill at Medicare schedule rebate only. This means that patients will not have to pay a gap. If we have received the patient's Medicare number and an assignment form we will pass this on to the reference laboratory for bulk-billing.
Where referred tests are not eligible for Medicare the reference laboratory will bill private inpatients and privately referred outpatients.
Services not eligible for Medicare
Tests or services that do not have a Medicare item number do not attract a Medicare rebate.