Inpatient Services

In-patient pathology tests are performed for patients who are admitted to a private hospital or approved day surgery facility and private patients in a public hospital.


Tests Covered by Medicare

 

  •  Patients with Private Health Cover


Patients who have private health insurance with a Health Fund that has a no-gap agreement with Capital Pathology may have their account billed directly to Medicare Australia and the Health Fund. The patient does not incur any additional out of pocket expenses.

Patients who have private health insurance with a Health Fund with which Capital Pathology has not entered into a "no-gap" agreement will receive an account for the testing performed during their stay in hospital. Medicare and the Health Fund will cover costs at 100% of the Medicare Benefits Schedule. The patient is responsible for payment of the balance. The latter amount stems from the fact that Capital Pathology's fees are based on those recommended by the Australian Medical Association (AMA). Rebates for the tests covered by Medicare can be claimed from Medicare Australia.

Please note: NIB is the largest health fund which does not have a "no-gap" arrangement with private pathology providers. All patients insured with NIB are responsible for their out-of-pocket costs.

 

  •  Patients without Private Health Cover

 

Uninsured patients are responsible for the settlement of pathology accounts. Rebates for the tests covered by
Medicare can be claimed from Medicare Australia.

 

Non-Medicare Rebatable Tests

Patients are billed privately for any/all tests not covered by Medicare. Where applicable, this cost is in addition to the cost of Medicare rebatable testing.