Pathology

19 May 25

There are telehealth wellness and “optimisation” clinics sending patients for Medicare funded tests to a 3rd party telehealth company that has agreed to provide Medicare funded testing automatically. The wellness company does this because they know the patients don’t qualify for Medicare funded pathology under their own clinic. Their attitude seems to be – ‘it’s them, not us, we are clean’. The 3rd party would need to have their own clear clinical reasons for ordering and that would be on them if not complaint. But how would it reflect on the original company knowingly engaging in this?

2 December 24

I am a GP. I have come across an issue with item number 11607. Our pathology company is billing 11607. They fit the patient with an ambulatory bp monitor and send a report to me from a cardiologist stating if the patient has hypertension and a brief recommendation. They do not provide a comprehensive treatment plan, provide any follow up, nor do they actually see the patient. Can the pathology company actually bill this item, or could the GP, as they use pathology to obtain the data and actually sit with the patient and makes recommendations re: medications, lifestyle, follow up and provides a written plan to the patient? Or is it neither can bill this item? 

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