Billing Policy
Under our 'No-Gap' Billing Policy, the IMVS 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.
A recent article by Choice, 'Mind the Gap' highlights the differences in billing practices of the IMVS, versus other South Australian pathology providers and their push to increase the number of people paying an out-of-pocket gap payment.
Rest assured, the IMVS will continue, as it has always, 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 patient collection centre, GP surgery or as a hospital outpatient.
Under our 'No-Gap' Billing Policy, the IMVS 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 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
The patient will be issued an invoice for in-hospital services. The patient must present this invoice to their health fund and Medicare. Under our 'No-Gap' Billing Policy, patients will receive a full refund.
Tests not performed by IMVS
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 the IMVS 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 the IMVS may choose to waive these fees.