Q: Why did I receive a pathology account?
A: QML Pathology is a private pathology provider and as such will bill for the pathology tests your doctor has requested. These tests may have been collected while you were in hospital, at the doctor's surgery or at one of our collection centres.
Q: What is your Out Patient (Non-Hospital) Billing Policy?
A:
Please see below for Out Patient (Non-Hospital) Billing Information:
Out Patient Pensioner or Health Care Cardholder
If you are a Pensioner or the holder of a current Health Care Card, QML Pathology will bulk bill you for all tests eligible under Medicare's rebate scheme. If you are bulk billed you will not receive an account from QML Pathology for Medicare rebated tests. Your account will be billed directly to Medicare. In order for this to occur it is essential that you sign the Pathology Request Form and present your Medicare Card, and Pension or Health Care Card.
Out Patient Veteran Affairs Gold Cardholder
If you are the holder of a Veteran Affairs Gold Card your account will be billed directly to the Department of Veteran Affairs.
Out Patient (with none of the above)
If you do not hold the concession cards mentioned above you will be privately billed. QML Pathology private fees are based on the Australian Medical Association (AMA) published List of Medical Services and Fees, however, QML Pathology's private fees are capped to ensure that no patient is out-of-pocket more than $75.00* for Medicare rebatable services.
*This applies to tests performed by QML Pathology for patients and tests that are eligible for Medicare rebates, and is the difference between the Medicare rebate and the QML Pathology private fee for services provided in one day, regardless of the number and complexity of services. An additional out-of-pocket expense will be incurred for patients or services which are not eligible for Medicare rebates.
Q: What is your In Patient (Hospital) Billing Policy?
A: See below for Hospital Patient Billing Information:
Information for In Patients with Private Health Insurance
We have agreements with a number of private health funds. If you have any queries regarding an agreement with your health fund please contact us on 1800 350 046. These agreements allow for certain health funds to be billed directly for your pathology services while you are a private patient in a public or private hospital.
If you have insurance with one of these agreed health funds you will not receive an account from QML Pathology. In this circumstance you will not incur out-of-pocket expenses for Medicare rebated tests performed by QML Pathology. If you have private health insurance but your health fund does not have an agreement with QML Pathology, you will receive an account. We have a gap protection policy that applies for each period of hospitalisation. After claiming from Medicare and your health fund the maximum out-of-pocket expense will be $300.00 per admission for tests eligible under Medicare's rebate scheme. This applies to tests performed by QML Pathology only.
Information for In Patients Pension and Health Care Cardholders with Private Insurance
If you are a current Pension Card or Health Care Cardholder and have private health insurance with one of our agreed health funds you will not receive an account from QML Pathology. If you hold one of these cards but do not have private health insurance with one of our agreed health funds, you will receive an account for pathology tests performed by us while you are a hospital in patient. Fees will be charged at the Medicare Schedule Fee and will be fully reimbursed by claiming through Medicare and your private health fund.
Information for In Patients without Private Health Insurance
If you are a patient without private health insurance and are not the holder of a Pension or current Health Care Card you will receive an account. You will be able to claim 75% of the scheduled fee through Medicare and will be required to pay the balance.
Information for In Patient Pension and Health Care Cardholders without Private Health Insurance
If you are the holder of a Pension Card or current Health Care Card and do not have private health insurance you will receive an account charged at the Medicare Schedule Fee. You will be able to claim 75% of the scheduled fee through Medicare and will be required to pay the balance.
Information for In Patient Veteran Affairs Gold Cardholders
If you are the holder of a Veteran Affairs Gold Card your account will be billed directly to the Department of Veteran Affairs for payment. You will not incur out-of-pocket expenses.
Q: What tests do not attract a Medicare rebate?
A: Some pathology tests are not eligible for a Medicare rebate and will incur a charge. Some of the more common tests in this category include ThinPrep, FISH and DNA. In addition to this, other tests such as HPV and Thrombotic Assays are only rebatable when certain medical criteria are met. If you are concerned in regards to charges associated with a test, please discuss with your doctor at the time of consultation. Alternatively, please contact our Accounts Department on 1800 350 046 for further clarification.
Q: How can the Medicare 'Safety Net' initative help me?
A: If you regularly undergo medical tests, it is important that you ensure you and your family members are registered with Medicare. By registering you will be protected by the government's 'Safety Net' initiative. This ensures that once you and your family reach a certain threshold for gap payments (this is the difference between the Schedule Fee and Medicare Rebate), that pathology tests or visits to your doctor attract a higher rebate.
As of January 2008, the 'Safety Net' scheme dictates that families who reach a $365.70 gap payment in any one calendar year are eligible to receive the full Schedule Fee Rebate for all further testing. This will substantially reduce gap payments; however, it is important to note that this does not apply to any testing performed while you are admitted to hospital. For further information or to register your family please visit the Medicare Australia website.
Q: I have lost my receipt, can I get another?
A: To obtain a receipt please contact our Accounts Department for assistance on 1800 350 046.
Q: I have received my bill. Can you please give me further information on my results and the tests that were performed?
A: Due to privacy legislation, we do not have the authority to give information other than that what which is outlined on your account. For clarification on testing and your results please speak directly with your doctor.