Billing Policy

Monash Pathology Billing Policy

For help with any fees not covered by the Medicare Benefits Schedule, please call the pathology inquiry line: Tel: +61 3 9594 43024 or +61 3 9594 43759

List of NON CMBS Tests (no patient rebate available)

Non-CMBS listing

Medicare Benefits Schedule

Medicare Benefits Schedule

Private Pathology Services for Non-hospital patients

Private Pathology Services for Non-hospital patients If you refer a patient from a Monash Health privatised clinic or from a General Practice, your patient you will be referred to the private pathology service

Will your patient receive a bill?

  1. Medicare Scheduled/ listed items
    Patients will be charged the standard Medicare scheduled fee and will receive an account.This means they can claim the Medicare rebate, and there will be a small out of pocket fee
  2. Tests not funded by the Commonwealth(Non CMBS tests)
    There are a small number of tests or services not funded by the Commonwealth, which are not listed with Medicare. For these tests no government rebate is available.Patients will receive an account and be responsible for the full amount. (This includes pensioners and healthcare card holders and veterans receiving NON CMBS tests in a private clinic)Please advise your patient of this when ordering these tests These tests will be charged at the standard pathology fee For help with any fees not covered by the Medicare Benefits Schedule, please call the pathology inquiry line: Tel +61 3 9594 43024 or +61 3 9594 43759 and our staff will assist you.
  3. Health care card holders, veterans and pensionersMonash Pathology will bulk-bill all patients with a health care card, blue or white veteran’s card or pension card who attend this private clinic, for all items listed in The Medicare Schedule.Patients must present their Medicare card, health care card or pension card on the day of service. As personal details must be current please advise staff on arrival of any changes. Patients who do not complete the assignment box on the bulk billing form will be issued an account, an assignment form and a stamped, self-addressed return envelope. The account will be cancelled if a signed assignment form is returned. Alternately, the account may be presented to Medicare for payment.Tests not funded by the Commonwealth (Non CMBS) See item b. above
  4. Overseas outpatients
    Overseas visitors not eligible for a Medicare card will be billed privately at the standard scheduled fee for all Medicare listed services. An invoice will be sent directly to you or to your health insurer.For any tests not funded by the Commonwealth, (non-CMBS tests) which do not have a Medicare item number, patients will receive an account and be responsible for the full amount. Foreign diplomats and their families are not covered unless they are from countries other than New Zealand, which have a reciprocal health care agreement (RHCA) with Australia. Australian residents must enrol in Medicare before any benefit can be paid.

Public Pathology Services for Non Hospital patients

Public Pathology Services for Non Hospital patients
Patients who have been referred from a Monash Health public clinic, and have elected to be bulk billed for tests, there will be no out of pocket expense for any tests.

In order to bulk-bill eligible services, all patient details must be correct. Please advise the staff on arrival of any changes to personal details. Monash Pathology requires a patient’s signature in the assignment box on the pathology request form, as well as the relevant Medicare or Department of Veterans’ Affairs information

Private Inpatients and Day Stay Patients

In most cases all patient billing will be sent directly to their Private Health Insurer. If for any reason this is not possible, the patient will be issued with an invoice, which they would need to present to Medicare and their Private Health Insurer.

Overseas “in patients”

Where an overseas patient has an agreement with a Health Insurer, the account will go directly to the insurer for payment. Overseas inpatients that have no agreement with a health insurer will receive an invoice and will be responsible for payment at the time of discharge.

Please note that in some cases, tests may be sent to an external laboratory who may invoice the patient directly

Reciprocal Health Care Agreements

The Australian Government has signed Reciprocal Health Care Agreements with some countries. These agreements provide some health services and subsidised medicines to visitors from these countries when they are in Australia.