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Billing Policy

Bulk Billing

Clinical Labs may be able to bulk bill the following: 

  • Pensioners
  • Healthcare Cardholders
  • Veterans Affairs Gold Cardholders

 *Some tests and conditions apply. Seniors Card and Commonwealth Seniors Health Cardholders are not eligible.

 

Outpatient Accounts

Outpatients will receive an account from Clinical Labs. These fees are aligned to Australian Medical Association (AMA) recommended rates. In some circumstances a 'co-payment' applies, this means that the Department of Human Services does not cover the entire invoice amount and patients need to pay the difference.   

Clinical Labs can lodge a claim to the Department of Human Services on a patient's behalf. Once the claim has been submitted to the Department of Human Services, they will assess it and send the patient a cheque for benefits payable.

To check eligibility for this please contact our customer service team on 1300 369 762.

WorkCover, Transport Accident Commission and Insurance Claims

If the referral is related to a WorkCover, Transport Accident Commission or insurance claim, then an account can be sent directly to those organisations. Patients will need to provide their claim number at every visit.

Pre-Employment, Immigration, Health Screening, Travel & Overseas Visitors

Testing for these groups are not eligible for Medicare rebates and an upfront payment is required. Insured overseas visitors will also need to pay up front and then claim back from their insurance company.

Overseas Students

If patients hold a current student insurance with Medibank Private, Allianz Global Assistance, AHM or BUPA we may be able to directly bill the insurer. If we are unable to directly bill the insurer then an upfront payment is required.

Private Hospital & Day Procedures Inpatients

 

Clinical Labs is committed to minimising "out of pocket" expenses to hospital and day procedure inpatients. Clinical Labs has "no gap" agreements in place with most major health funds, however for those patients who belong to a fund where agreements are not in place, a pathology account will be issued. Click here for a print friendly pdf.

Participating Funds with "No Gap" Agreements

  • ACA Health Benefits Fund
  • Australian Unity Health Limited
  • Budget Direct
  • BUPA
  • CBHS Corporate Health
  • CBHS Health Fund Limited
  • Central West Health Cover
  • CUA Health Limited
  • Defence Health
  • Emergency Services Health
  • Frank Health Insurance
  • GMF Health
  • GMHBA
  • GU Health
  • HBF (WA Only)
  • Health Care Insurance Limited
  • Health.com.au
  • Health Partners
  • Health Insurance Fund of Australia Limited
  • HCF
  • Navy Health Ltd
  • Nurses and Midwives Health
  • Onemedifund
  • Peoplecare Health Insurance
  • Phoenix Health
  • Police Health
  • Queensland Country Health Fund Limited
  • Reserve Bank Health Society 
    Limited
  • RT Health Fund
  • Teachers Health Fund
  • TUH
  • The Doctors Health Fund
  • Transport Health
  • UniHealth Insurance

Note: Type of hospital cover and conditions governing waiting periods should be checked with the fund to ensure no "out of pocket" charges.

Non-Participating Funds

For patients who belong to one of the following funds, there may be an “out of pocket” charge for pathology tests.

  • Australian Health Management (AHM)*
  • HBF (All states excluding WA)
  • Latrobe
  • Medibank Private*
  • Mildura District Health Fund
  • NIB
  • Westfund

 

Note: Medibank Private and Australian Health Management no longer provide full insurance cover for inpatient Pathology
services. These funds phased out their agreements with Pathology from 1 October 2014. Patients insured with Medibank
Private or Australian Health Management will now receive an account for “out of pocket” expenses for inpatient
Pathology services.


Australian Clinical Labs apologises for this change to our billing policy brought about by changes to insurance cover
offered to Medibank Private and Australian Health Management members. All queries in relation to health insurance
policy cover and terms and conditions should be directed to the relevant insurer.

 

Fees

The fees at Australian Clinical Labs are based on Australian Medical Association (AMA) recommended rates and whilst there will be an "out of pocket" charge for members of non-participating funds, this "gap" fee will not exceed $500 for the whole hospital stay.  

Veterans' Affairs Gold Cardholders

Veterans' Affairs Gold Cardholders should present their card to our collection staff and Australian Clinical Labs will bill the Department of Veterans' Affairs directly.

 

Medicare Safety Net

Patients should remember to register with the Department of Human Services so that they are eligible for benefits under the revised Medicare Safety Net. Please refer to the Department of Human Services website for your eligibility and entitlements.

How do Patients Pay Their Accounts?

Clinical Labs sends patients an account upon completion of a test. The following payment options are set out on the account:

  • Pay the account in full and an official receipt will be forwarded to the patient. The patient will need the receipt and invoice to claim a rebate from Medicare if eligible. 
  • Clinical Labs can directly submit a claim to the Department of Human Services. The Department of Human Services will then send the patient a cheque which they will then need to forward to us with any additional outstanding payment.
Payment Methods:
  • Bpay: Please refer to tear-off bottom slip of the invoice for our biller code and reference number
  • Telephone: Call 1300 369 762 and have credit card details ready (Visa or Mastercard only)
  • Internet: Access our Online Payment Service