Hospital Inpatient Billing

If you have chosen to personally pay your account, send or take your receipt and invoice to Medicare and your health fund to claim for rebates. 
 
Patients with Private Health Insurance (including Pension and Health care Card holders)
 
If you have pathology services referred to PathWest Laboratory Medicine WA whilst you were a private patient in a public or private hospital, and you are privately insured with any of the health funds, you will be charged at a no gap level.  What this means is that you will not receive any out-of-pocket expenses relating to pathology referred to PathWest Laboratory Medicine WA during your hospital stay.
 
Patients without Private Health Insurance (including Pension and Health Care Card holders)
 
If you are a patient without private health insurance you will receive an account.  You will be able to claim 75% of the scheduled fee through Medicare, and you will be required to pay the balance.
 
 
Hospital Benefit Fund of WA (HBF) members
 
At present we are only able to send accounts directly to the Hospital Benefit Fund of WA (HBF).  If you are a HBF member we will forward your account directly to HBF, you will not receive an account from PathWest Laboratory Medicine WA.
In the event that you do receive an invoice, please contact PathWest Accounts Receivable and provide your Medicare card number and HBF member number in order for us to be able to redirect your account to HBF.
 
Other Health Funds
 
For other Health Fund members (non HBF members and non Two – Way Scheme), you will receive an account for all of your pathology tests performed over the length of your hospital stay.  Please complete the standard Medicare claim form to submit to Medicare and a separate Health Fund claim form to submit to your Private Health Fund.  The rebate cheques will be sent to you, to then be forwarded to Pathwest Accounts Receivable.
 
Two – Way Scheme Health Funds
 
For Health Funds that participate in the Two-Way scheme, (See list of participating health funds), you will receive an account for all of your pathology tests performed over the length of your hospital stay.  Please complete a Standard Medicare claim form and a Medicare Two-Way claim form.  Send or take these claim forms and your invoice to Medicare.  The rebate cheques will be returned to you, to then be forwarded to PathWest Accounts Receivable.
 
Two – Way Scheme Participating Health Funds
·         ACA Health Benefits Fund (ACA)
·         Mildura District Hospital Fund Limited (MDH)
·         Australian Health Management Group (AHM)
o    Government Employees Health Fund (GEH)
o    Illawarra Health Fund (IHF)
o    Australian Country Health (ACH)
o    Mutual Health (MHF)
o    Overseas student Health Cover (OSH)
·         Navy Health Limited (NHB)
·         NIB Health Funds Limited (NIB)
·         Phoenix Health Fund Limited (PHF)
·         Police Health (POL)
·         Onemedifund (OMF)
·         Queensland Country Health Limited (QCH)
·         Australian Unity Health Limited (AUH)
·         Queensland Teachers Union (QTU)
·         BUPA Australia Health Pty Ltd (BUP)
o    HBA (HBA)
o    ANZ Health (ANZ)
o    Mutual Community Limited (MCL)
o    TIO (formerly Territory Mutual) (TIO)
o    The Card Members Health Insurance Plan AMEX (AMX)
o    CSR Health Plan (CSR)
o    Super Members Health Plan (SMH)
o    Health Cover Direct (HCD)
o    St George (STG)
·         Railway & Transport Health Fund Ltd (RTH)
·         Reserve Bank Health Society Limited (RBH)
·         St Lukes Medical and Hospital Benefits Association LTD (SLM)
·         Teachers Federation Health Ltd. NSW (TFH)
·         Transport Health (TFS)
·         Westfund (WDH)
·         Cessnock District Health Benefits (CDH)
 
·         CBHS Friendly Society Limited (CBH)
 
·         CUA Health (CHF)
 
·         Defence Health Limited (DHF)
 
·         The Doctors' Health Fund Limited (AMA)
 
·         GMF Health (GMF)
 
·         GMHBA Limited (GMH)
 
·         Health Care Insurance Limited (HCI)
 
·         Health Insurance Fund of WA (HIF)
Page last updated: 24 Aug 2016