Payment & Health Insurance
Medical bills can sometimes be complex and confusing. Our goal is to provide you with clear and transparent information about your bill and our billing process.
Important information regarding your bill
ParkwayHealth works to provide you with a comprehensive, quality driven healthcare service for you and your entire family.
As a private healthcare service we operate on a fee for service basis. On the day of your visit the ParkwayHealth staff will prepare a bill for you. The bill will include the cost of your consult with our medical/healthcare team and, depending on your health requirements, the cost of any pathology or investigations performed on the day and any medications prescribed and dispensed. Any ongoing treatment, follow-up, referrals or investigations will be charged separately.
Patients with healthcare insurance are often entitled to benefits that will cover a varying degree of the costs incurred. The amount of money you receive toward your bill is dependent upon the type of health insurance policy you have and what agreement you have with your insurer. Any costs that are not covered by your insurer are paid directly by you.
For your convenience Parkway Health, in partnership with a number of insurers, is able to offer many of its patients a direct billing service. A comprehensive list of insurers that allow direct billing is available at the billing desk located in each clinic.
Direct billing allows ParkwayHealth (on your behalf) to prepare and submit your initial claim directly to the insurer for their consideration. This not only saves you time, it often results in a reduction in the total amount of money you need to pay on the day of your visit.
Direct billing does not guarantee that the insurer will approve and pay the total amount of your bill. Each claim submitted via direct billing is assessed by your insurer and the total amount of benefit your insurer provides is dependent upon their assessment and your policy entitlements. As a healthcare provider we do not have any influence over what is covered and what is not covered.
Some insurance policies have a co-payment component or will exclude the payment of certain services. Co-payments and known service exclusions will be billed directly to you on the day of service, for payment on the day of service. Where appropriate the remaining costs may be direct billed.
When part or all of a claim is rejected by your insurer, ParkwayHealth will notify you and a bill for the outstanding amount will be forwarded to you. It is important to note that it can take up to 6 months for the insurer to notify Parkway Health of a claim rejection. If you feel that you are entitled to the benefit, you can appeal directly to your insurer and ask them to reassess the claim. (Please note that some insurers will take several months to assess a claim). The insurers contact details can be found on the the back side of your insurance card.
To ensure you gain maximum benefit from your healthcare insurance/benefits and that your current policy meets your healthcare needs we recommend that you familiarize yourself fully with your policy and benefits available to you prior to your appointment. We suggest that you keep a copy of any written correspondence regarding your health insurance.
Patients without health insurance may access all the healthcare services ParkwayHealth provide, however the cost of the services must be paid in full.
Each clinic provides a price list of their key services and a service quote can be prepared for you.
It is important to remember that the cost of a Doctor's consultation does not include the cost of any investigations, pathology, medications, ongoing treatment or referrals.
Important information about your medications
Each ParkwayHealth Clinic has a pharmacy located on site.
For your convenience each pharmacy stocks a number of over the counter (OTC) medications for purchase.
OTC medications/preparations are medications that are often available at local drug stores or pharmacies and generally do not require a doctor's prescription. Over the counter medications include things like Paracetamol, Tylenol, throat lozenges etc.
If your doctor/healthcare professional thinks you may benefit from an OTC medication/preparation they will advise the pharmacists and you can choose to purchase them from the on-site pharmacy if you want/need them. ParkwayHealth is unable to direct bill the insurers for the cost of OTC medications. However ParkwayHealth will provide you a receipt of purchase, which can be submitted to your insurer for consideration.
The cost of prescription medication will be included in your bill and the amount of benefits you receive toward your prescription medications is dependent upon your insurance/benefit.
If you have any questions about your bill, the billing team located at your clinic will be happy to discuss it with you.