Douglass Hanly Moir Pathology Billing Policy - Effective from 1st November 2009
 

Douglass Hanly Moir is a private pathology laboratory. The fees for pathology testing are separate from the fees charged by other treating doctors. 

Medicare Rebate Eligibility

The following billing policy applies only to patients who are eligible for a Medicare rebate and for tests listed in the Medicare Benefits Schedule.

Your Medicare rebate is the subsidy provided by the Australian government for tests that are included in the Medicare Benefits Schedule. If any of your tests are not covered in this Schedule you will not receive a rebate. You will need to pay for these tests in full. For more information about personal and test eligibility visit the Medicare link at www.humanservices.gov.au or contact Medicare on 132 011.  

Outpatient (Community Based) Pathology Services

Concessional patients (see above) will be bulk billed and will not receive an account from Douglass Hanly Moir Pathology.
Non-concessional patients may be privately billed and receive an account from Douglass Hanly Moir Pathology. Our fees are based on the Australian Medical Association (AMA) schedule of fees. We limit your out-of-pocket expenses by applying a maximum gap per episode of $150. When you have paid your account you can submit the receipt to Medicare to claim the rebate.
 

Inpatient (Hospital) Pathology Services

Inpatient pathology services refer to tests performed on: 

  • A private patient in a private hospital or approved day hospital facility, or
  • A private patient in a recognised (public) hospital    
 

 

Fees for In-Patients who have eligible cover with a private insurer with whom Douglass Hanly Moir Pathology and Barratt & Smith Pathology have a "No-Gap" agreement. 

Any hospital in-patient, who is a member of a major health fund with whom Douglass Hanly Moir Pathology and Barratt & Smith Pathology has a "No-Gap" agreement, will not incur "out-of-pocket" expenses for Medicare rebatable pathology referred to Douglass Hanly Moir Pathology and Barratt & Smith Pathology.

Patients may have pathology tests performed during their stay in hospital. These costs are covered by most of the major health funds including HCF, MediBank Private and BUPA (MBF). If you have insurance cover with one of these funds, your account will be billed directly to Medicare Australia and your private health insurer for full payment. You will not incur any additional out of pocket expenses.

 

Fees for In-Patients who do not have eligible cover as outlined above.                                                  

If you do not have insurance cover with a private health insurer with whom Douglass Hanly Moir Pathology and Barratt & Smith Pathology has a "No-Gap" agreement, you will receive an account for your pathology tests.

Your pathology tests may be charged according to the Australian Medical Association (AMA) schedule of fees. When the account is paid you can present the receipt to Medicare Australia to claim the rebate which will amount to 75% of the Medicare Schedule fee and if applicable, your private health insurer to claim their rebates. The difference between our fees and the sum of these rebates is your out-of-pocket expense. We limit your out-of-pocket expenses by applying a maximum gap of $500 per hospital stay.

 

Out-of-Pocket Expenses

Out-of-pocket expenses are incurred when the private account from Douglass Hanly Moir Pathology exceeds the sum of rebates payable by Medicare Australia and/or your private health insurance fund. When we issue a private account we limit our fees so that your out-of-pocket expenses are kept to a minimum. 

The maximum out-of-pocket payment for medicare-eligible outpatient pathology tests performed on a single day, regardless of number or complexity of tests, is $150. 

The maximum out-of-pocket payment for medicare-eligible inpatient pathology tests performed during a single admission to hospital, regardless of number or complexity of tests or duration of admission, is $500.

 

Paying your Account 

AusPost 

Australia Post Office.  The receipt you receive can be used to claim your Medicare rebate. 

 BPay BPay Internet Banking.  The reference number is unique; you will need to change this number for each new account.  Your receipt will be mailed to you. 
   
 phone

Phone - Credit Card 1300 135 139.  Phone facility 24 hours per day, 7 days per week. Your receipt will be mailed to you. 

 Online

Website.  Pay your account online. Pay Your Account Online 

You may pay by cash, cheque or credit card, at any of our collection rooms. Please refer to our website for a convenient collection centre.   

 

Claiming your Rebate 

When the account is paid, you can submit the receipt to Medicare to claim your rebate. Your Medicare rebate is the subsidy provided by the Australian government for services that are included in the Medicare Benefits Schedule. If any of your tests are not covered in this Schedule, you will not receive a rebate. You will need to pay for these tests in full.                                                      

For more information about personal and test eligibility, visit the Medicare link at www.humanservices.gov.au or contact Medicare on 132 011. 

If you need assistance, please contact our Accounts department on 02 98 555 500 or 1800 015 973.  

   

 

All pathology tests incur a fee, however, Douglass Hanly Moir Pathology offers discounted fees to "concessional" patients for Medicare rebatable tests only.

Concessional Patients    

If you fall into one of the following categories, you will qualify for concessional fees;

  • Holders of a current Health Care Card

 Healthcare card

  • Holders of a current Pensioner Card

 Pensioner card

  • Holders of a current Veterans Affairs Card

  Repat 

  • Nursing home patients 
  • Patients over 80 years of age