Frequently asked questions
Learn more about Medicare eligibility, gap fees, health care holder exemptions, inpatient billing and private health insurance cover in our frequently asked questions.
Frequently asked questions
Learn more about Medicare eligibility, gap fees, health care holder exemptions, inpatient billing and private health insurance cover in our frequently asked questions.
Is my medical imaging procedure covered by Medicare?
Many medical imaging procedures are partially covered by a Medicare rebate, meaning the rebate from Medicare is often less than the actual cost of providing the service. For this reason, there is usually a 'gap' payment charged to the patient. The gap payment is the difference between the fee for our services and the Medicare rebate. The size of the gap payment varies depending on the type and number of tests, and the complexity. Additionally, for some tests, there may not be a Medicare rebate at all. See below for information for pensioners and healthcare card holders.
To discuss the cost of your imaging procedure, contact I-MED Radiology by calling your local clinic and select the 'Booking' option in our phone system. Find your local clinic details here.
Why is there no Medicare rebate for my medical imaging procedure?
There are a few procedures that are not included in the Medicare Benefits Scheme and as such, there is no rebate available. For these procedures, I-MED Radiology will issue an invoice and the patient is responsible for payment of this invoice on the day. Patients are advised of costs associated with their procedure or examination at the time of booking their appointment.
What is the 'Gap fee' or 'out-of-pocket' expense?
A ‘Gap fee’ or ‘out-of-pocket' expense is the difference between any Medicare rebate you receive and I-MED Radiology's fee for this examination or procedure. The size of the gap or out-of-pocket expense depends on the type of examination or procedure requested by the requesting practitioner.
What if I am a pensioner or healthcare card holder?
Pensioners and healthcare card holders are bulk billed or billed at a discounted rate for some Medicare rebateable imaging procedures. There are a small number of services (such as after hours examinations) that are not eligible for the discounted rate.
Most interventional procedures will incur an out-of-pocket fee.
What if I am a Veterans Affairs card holder?
The Department of Veterans Affairs (DVA) covers the cost of x-rays, nuclear medicine imaging, ultrasound and CT for Gold DVA cardholders. Some procedures, such as MRI and PET are not automatically covered for Gold DVA cardholders without preapproval being organised. DVA White cardholders have more limited cover. All DVA cardholders are advised to contact the DVA to discuss their coverage prior to any medical imaging examination or procedure. I-MED advises patients of costs associated with their procedure or examination at the time of booking their appointment.
I attended a private A&E (Emergency) department and paid the hospital – why have I received an account?
I-MED Radiology act as a third-party provider of services in many private hospitals. In the emergency department, the staff at the hospital ask you to sign an Informed Financial Consent form explaining the fees that they charge at the Emergency Centre and also that, where performed, you will receive an invoice for any tests which the hospital cannot provide, such as pathology, diagnostic imaging, pharmacy or medical aides. As such, I-MED Radiology charges fees for radiology services which are provided at the request of a treating Accident & Emergency doctor, which are not covered in your payment to the hospital.
Services performed in A&E departments are considered outpatient visits by private health funds and are therefore not subject to any fund rebate – even if you are later admitted to hospital. As such, services performed in emergency departments will be invoiced accordingly and accounts will be issued via SMS, Email or Post (subject to information provided to us by the hospital) the business day after you attended the department. Services which are eligible for a Medicare rebate will be claimed electronically on your behalf once payment in full has been received.
My procedure was performed during an inpatient visit at a private hospital. Will my private health fund cover the cost?
For inpatient treatment at private hospital facilities, I-MED Radiology seeks to maintain a “no gap” agreement with most major private health funds. If you belong to one of these funds, you will not incur out-of-pocket expenses for medical imaging services that are eligible for the Medicare rebate. If your private health fund does not have a “no gap” agreement with I-MED Radiology or the service is not eligible for a Medicare rebate, you may incur additional fees while you are an inpatient.
I-MED Radiology supports affordable healthcare, and we cap out-of-pocket expenses for medical imaging services per hospital admission. Note that this fee cap does not apply to imaging services provided outside of normal business hours, and for imaging services and medical consumables not covered by Medicare or your private health fund. For more on inpatient fees information, please click here.
What is the inpatient 'cap'?
I-MED Radiology recognises that at times, hospital stays can result in large out-of-pocket expenses for patients. To ease this cost burden, in some I-MED clinics, the out-of-pocket expense for medical imaging services is capped per hospital admission. Please contact us on (03) 8587 5344 during business hours (Mon-Fri) for the current cap level. Please note that this fee cap does not apply to imaging services provided outside normal business hours or for imaging services of medical consumables not covered by Medicare or a private health fund.
What does my private health insurance cover?
Private health insurance covers medical imaging services for private hospital inpatients (ie patients who are admitted to a private hospital) only. The level of coverage depends on the individual health fund and any agreements that may be in place. We advise all inpatients to contact their private health fund to confirm whether imaging services are covered by their policy.
What is an after-hours surcharge?
If you require medical imaging services outside normal business hours, an additional charge – known as an ‘after hours surcharge’ – may be incurred. This surcharge is in addition to the standard I-MED Radiology fee. Surcharges are not claimable via Medicare or private health funds. Concession card discounts do not apply to after hours’ surcharges.
What if I am covered under workers' compensation?
For Workcover or TAC/MVA claimants, I-MED Radiology will invoice your agent directly with the relevant claim and approval number. It is important that you provide us with the details of your insurance company, employer and claim details at the time of booking your examination, you will also be asked to provide this information again at the time of your examination to avoid any delays. All Workcover or TAC/MVA MRI services will require a pre-approval letter from your employer or the insurance company to state they will be liable for the cost of the MRI service. Please note that if an invoice is rejected, the patient is responsible for payment. If you are unsure if your examination will be covered, please contact your employer or agent to discuss prior to your appointment with I-MED Radiology.
When and how do I pay my account?
All patients are asked to settle their account in full on the day of their examination or procedure, if the service provided is eligible for a Medicare rebate the clinic staff may claim the invoice with Medicare on the patients behalf. Medicare will pay the rebate into the nominated bank account registered with them within 24-48 hours. All I-MED Radiology clinics accept payment via cash, money order, EFT and credit card (Visa and MasterCard only).
Should patients experience difficulties paying their account, they are encouraged to contact our Accounts Department on (03) 8587 5344 (Mon-Fri) during business hours, or by email at Accounts@i-med.com.au. Please note that our Accounts team are based in Melbourne, therefore business hours are based on local Melbourne time.
If you have difficulties paying for your account in full on the day of the examination, please speak with the clinic you visited to discuss payment options.