Billing Policy
Under our 'No-Gap' Billing Policy, IMVS Pathology bills through Medicare and the Department of Veterans Affairs (DVA), so that patients do not have to pay a gap for their pathology testing for all items covered under the Medicare Benefits Schedule.
An article by Choice, 'Mind the Gap' highlights the differences in billing practices between IMVS Pathology and other South Australian pathology providers.
Rest assured, IMVS Pathology will continue, as it always has, the practice of directly billing Medicare ('bulk billing') for all referrals (for Medicare card and DVA card holders) for tests covered under the Medicare Benefits Schedule.
Specific information for different patients and services is available below.
Non-hospital patients
This category applies to patients who have their specimens collected from an IMVS Pathology patient collection centre, GP surgery or as a hospital outpatient.
Under our 'No-Gap' Billing Policy, IMVS Pathology bills through Medicare and the Department of Veterans Affairs (DVA), so that patients do not have to pay a gap for their pathology testing, for all items covered under the Medicare Benefits Schedule.
We require a patient's Medicare or DVA number and signature in the assignment box on the request form to bulk-bill eligible services.
Patients who do not complete the assignment box will be issued an account and an assignment form. The account will be cancelled if a signed assignment form is returned, as this enables IMVS Pathology to bill Medicare or DVA directly for the services provided. Alternatively, the account may be presented to Medicare for payment.
Private Inpatients and Day Stay Patients
In most cases your bill will be electronically sent directly to your Private Health Insurer. However if this is not possible, you will be issued with an invoice, which you will need to present to Medicare and your Private Health Insurer. Under our 'No-Gap' Billing Policy, you will receive a full refund.
Tests not performed by IMVS Pathology
There are a small number of very specialised pathology tests that are performed only at a few reference laboratories interstate, and occasionally overseas.
Where possible, we choose Australian reference laboratories that bill the Medicare schedule rebate so that patients will not have to pay a gap.
Occasionally the referred tests are not charged at the Medicare rate and /or are not eligible for Medicare. On those occasions the reference laboratory will bill the patient according to their billing policy.
Services not eligible for Medicare rebate
A minority of tests or services are not funded by the Commonwealth and therefore do not have a Medicare item number and so do not attract a Medicare rebate. Services not eligible for Medicare rebate are listed for patients' reference.
In those cases the cost of the test will be privately billed. Prior to requesting such tests an estimate of the cost should be obtained by calling IMVS Pathology on 08 8222 3000.
Overseas patients not eligible for a Medicare card or DVA card will be billed privately at the 'bulk billing rate' (85% of MBS schedule) for all services recognised under Medicare. A pathology account will be sent directly to the patient. In cases of extreme hardship or for humanitarian reasons IMVS Pathology may choose to waive these fees.