Been to hospital?

Been to hospital?

Information to help decide what to do next.

Medical Gap: how to claim on medical inpatient accounts

Latrobe pays an additional benefit above the Medicare schedule fee for the following claiming options:


Provider bills Latrobe Health Services direct
If your doctor is going to bill Latrobe directly then you will only be responsible to pay any out of pocket charges the doctor may apply. However, for your doctor to bill Latrobe directly they are to have advised you of any out of pocket charges up front.


Electronic two-way accounts
If your doctor bills you directly, to ensure that you receive the maximum benefit payable, we recommend that you submit your completed Latrobe and Medicare claim forms, along with your accounts and receipts to Latrobe Health Services. We will then submit your account to Medicare on your behalf. After Medicare has assessed your claim(s) it will be returned to us for processing according to the instructions on your claim form.

If Medicare is unable to submit your claim back to us, they will send you a benefit statement, which you will need to forward to Latrobe. To prevent delays in processing your claim, please ensure all your information is entered correctly on the claim forms.


Direct to Medicare
If your accounts are lodged directly to Medicare in the first instance, no additional benefits can be paid without a completed Latrobe claim form. We will assess your claim for the gap payment up to the schedule fee and send you a letter to confirm the Informed Financial Consent and other relevant questions required to be completed. Once returned we will adjust the account accordingly.

Any follow up or prior appointments will not be covered by your health insurance. Your hospital cover only covers your medical accounts whilst you are an inpatient in hospital.