Virtus Diagnostics Billing Statement
Updated: 18th August 2020
Virtus Diagnostics Pathology, a member of Virtus Health, will bulk-bill the majority of tests permitted under the Medicare Benefits Scheme (MBS) for eligible patients.
There are rare instances however where an invoice will be sent to the patient for prompt payment when one of the following conditions apply:
- The test requested is not covered for full or partial rebate under the MBS rules at the time the analysis was performed.
- One example is Anti-Mullerian Hormone (AMH); NO Medicare benefit is payable at any time.
- Another example is a request for Prostate Specific Antigen (PSA), where certain clinical criteria must be met for Medicare to cover the cost of the test.
- The request form is not signed and completed in compliance with Medicare rules and regulations.
- Tests that Virtus Diagnostics has sent to an external reference laboratory.
- You are an inpatient or day patient at a Private Hospital, have been privately billed by Virtus Diagnostics, and once paid you need to claim your rebate through your private health fund if the test is claimable.
Please refer to our Frequent Asked Questions (FAQ) & Answers section below for more information.
You can also find additional information on the Department of Health’s (DOH)Pathology page:
https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pathology-aboutus-index.htm
Please contact our accounts team on 1800 090 325 or:
Email Us with all of your billing enquiries
Frequently Asked Questions (FAQ) & Answers
Virtus Diagnostics may on occasions require you to pay for your pathology tests. This could be for a number of reasons including:
- Patient is not eligible or the test performed does not have an eligible Medicare Benefits Scheme (MBS) item to cover the cost of the test.
- The test has not been performed by Virtus Diagnostics
- You are a patient in a private hospital.
There may be a number of reasons for this including:
- You were a private hospital patient
- The test(s) are not eligible under current Medicare rules
- Your test(s) did not comply with Medicare bulk-billing
- Your tests had to be performed by an external specialised facility or laboratory that is not associated with Virtus Diagnostics.
Not all tests are eligible for the Medicare Rebate and these tests must be paid in full. Please refer to our Non-Rebatable Test List for the most common tests that fall under this category.
Alternatively, you may search for the full list on the Medicare Benefits Schedule website:
http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home
Private billing will apply to patients that do not meet the Medicare bulk-billing criteria.
If you are a Veteran Affairs Gold Cardholder, you will not incur out-of-pocket expenses for any pathology testing undertaken by Virtus Diagnostics. We will bill your tests directly to the Department of Veteran’s Affairs for payment.
We will also cover the cost of tests that may have exceeded the maximum allowable items in a specific period as per current MBS schedules if you hold an Aged Pensioner Card (Commonwealth Senior’s Health Card) or DVA Gold Card.
If undergoing a treatment cycle, there are insurance arrangements to cover the cost of non-Medicare Rebatable pathology tests. You will need to provide a valid ADF Service Number and the DoD Approval number, otherwise, you will receive an invoice from Virtus Diagnostics.
You can settle your pathology account online via BPAY or Credit card payment. You can also pay over the phone with our friendly accounts team. Once payment is made, you will be issued with an itemised invoice and receipt which you can send to Medicare or your private health insurer; you may receive a cash rebate based on your specific eligibility and circumstances.
For more information regarding your account or to make an over the phone payment, please phone 1800 090 325 or email us at:
The rules governing the eligibility criteria for Medicare rebate are set by the Department of Health and stipulated in the Medicare Benefits Schedule (MBS) document. The MBS stipulates the fee for the test and a description of the test performed and payable under the listed MBS item.
MBS rules govern and apply limits as to how many times they will pay for a test performed in a given time frame.
For example, Vitamin B12 will only be paid once in a 12 month period, irrespective of which pathology provider you may have visited for the performance of the Vitamin B12 test. Exemptions may be applied if you are an Aged Pensioner Card (Commonwealth Senior’s Health Card), DVA Gold Card holder or eligible Department of Defence personnel.
For the full list of tests and conditional criteria for Medicare rebate eligibility, please click here.
For more information, visit the Department of Health at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/pathqa
Online payments and credit card transactions may typically take 1 to 3 business days to process and settle into our account. Once we have received the funds, we will process the payment against your bill and send you an itemised invoice and receipt for your records that you can use for claiming purposes.
The receiving banks often take 2-4 days for funds to be released to the customer because they are following what they typically refer to as the “three-day good funds model”, which basically means that they may hold the funds for three days to ensure it is not a fraudulent transaction.
