Billing Questions and Answers

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Q. Does SEALS Bulk bill?
Yes, SEALS will bulk bill all privately referred, non-admitted patients, who have presented their Medicare Card to the Pathology Collector and signed a Medicare / Assignment form.    

Q. I am a DVA patient, will I receive an invoice?
 If you hold a DVA gold card, you should not receive an invoice from SEALS. Your invoice will be sent directly to the Department of Veterans Affairs for processing. If you have received an invoice from SEALS in error, contact the Billing Services Centre.   Please note that Department of Veterans Affair will only pay for tests that are covered by Medicare. If your Doctor has requested tests not covered by Medicare, you will be responsible for payment of those invoices.

 Q. I have never been to SEALS so why am I receiving an invoice from SEALS?
 
At times, the laboratory that is performing your tests may not have the facilities to perform a specialised test your Doctor has requested. In these circumstances, your sample will be sent to second laboratory, i.e. SEALS to complete the testing.

Q. Does Medicare pay for all pathology tests?
 
Medicare will pay for all pathology tests that are clinically relevant, ordered by a registered Doctor and are included in the Medicare Benefit Schedule. Pathology tests not covered by Medicare are found in the ‘test not covered by Medicare’ section.

 Also, pathology tests ordered for the following situations are not eligible for Medicare rebates ::
a) Tests ordered by a non-Medical Practitioner 
b) Tests ordered for Work Cover 
c) Tests ordered for employment 
d)  Tests ordered for immigration 
e)  Tests ordered for visa applications 
f)  Tests ordered for superannuation 
h)  Tests ordered for life insurance.

 Q. I paid my Doctor after a consult and now I receive an invoice from SEALS. Why?
 
Pathology fees are unrelated to any other fee you may have paid to your Doctor.

 Q. I have received an invoice from SEALS, what do I do?
 Pay your account in full, by cheque, phone or e-mail. Once you receive a receipt for the payment, take your receipt and invoice to a Medicare office for reimbursement. If you were an admitted patient in a recognised hospital, you will also be able to get a reimbursement from your private health insurance.

 Q. I was an admitted private patient in a recognised hospital and after claiming from Medicare there seems to be a gap. Do I need to pay for this if I am not enrolled in a Private Health fund?
 
All invoices raised as a private inpatient services, can claim 75% from Medicare and 25% from your Private Health fund. If you are not enrolled in a Private Health fund, you will need to pay the 25% personally. No exceptions.

 Q. I was admitted in a hospital, but do not recall having any blood sample or specimen collected for testing. Why have you billed me?
 
You may not recall a sample being collected if the sample was collected during an operation by a surgeon, by a nurse from your IV line during recuperation, or if you were unconscious.

 Q. Can I pay my pathology invoice in cash at SEALS?
 
No, SEALS does not have any cash facilities. You can pay your invoice at any hospital cashiers

 Q. I have received some cheques from Medicare and the Health Fund. What do I do?
 
Place all cheques along with the Medicare and health fund payment statements in an envelope and send to:
 SEALS
Locked Mail Bag No. 2015
Randwick NSW 2031
 
If you do not send the payment statement along with the relevant cheques, there is a possibility that the wrong invoice will be cleared.
 
Q. I have lost my invoice. How do I get a duplicate copy?
 
Contact the Billing Services Centre on (+612) 9382 3669 or (+612) 9382 3649.
 
Q. I do not have a copy of my pathology results. How do I get a copy?
 
SEALS cannot provide you directly with a copy of the results. You will need to contact your referring doctor for a copy of the results.
 
Q. Will I be able to claim from Medicare and my Health Fund if my name at the hospital is not the same as Medicare?
 
It is very important that you register with each organisation in exactly the same way. If you have registered your date of birth or your full name differently with any of these organisations, you will not be able to receive any re-imbursement from Medicare or your health fund.
 
Q. Why have I received an invoice for pathology performed on my newborn?
 
Pathology can only be claimed from Medicare and a health fund if your newborn is registered with them. If you have not registered your newborn you will be sent an account for payment of all privately referred pathology. Please submit your invoice to Medicare once you have registered your baby with Medicare.
 
CONTACT:
 Billing Services Centre between 8:00am-4:00pm Monday to Friday. The offices are closed on Public Holidays.
 The following details are for Pathology invoice queries. 
Phone: (+612) 9382 3669
             (+612) 9382 3649
 Fax:     (+612) 9382 3047
 E-mail:   revenue@sesiahs.health.nsw.gov.au

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