Inpatient medical Imaging Services
Costs relating to diagnostic imaging examinations performed during an inpatient admission can generally be claimed against your private health insurance.
Health Funds which have a ‘No-GAP’ agreement with Lumus Imaging
The Health Funds listed in the table below have a ‘No-GAP’ agreement with Lumus Imaging. If your Health Fund is listed in the table below, you will NOT have an out of-pocket expense (gap fee) for any Medicare eligible inpatient examinations. Lumus Imaging will submit claims to your Health Fund on your behalf. If an examination that is not eligible for Medicare is requested, you will be advised of the out-of-pocket expense and will be required to sign a financial consent form.
| QML Code | Class | Private health fund | Codes hospitals may use |
|---|---|---|---|
| ACA | MO4 | ACA Health Benefits Fund | ACAM |
| AMA | M50 | AMA Health Fund | AMAM |
| AOF | M27 | AOF WA | |
| API | MO8 | API Health Linx | |
| AUF | M15 | Australian Unity Health | |
| BUPA | M57 | BUPA Fund | BUPA, BUA, ANZ, AXA Australian Friendly Society Mutual Community SGIC Health, SGIO Health TIO Agent for NT |
| CBH | M16 | CBHS Health Fund | CBHA-AHSA |
| CHF | M17 | CUA Health Fund Limited (Credicare) | CHFM-CPS/HFCRE |
| DEF | M05 | Defence Health | AHB |
| DFS | M18 | Druids Friendly Society | DFSM-DRNSW |
| FFS | M28 | Forester Friendly Society | |
| GMF | M53 | GMF Health Fund | GMFM Redihealth Sunhealth |
| GUC | M19 | Grand United Corporate Health | FAI |
| GUH | M20 | Grand United Health Fund | |
| HBA | M46 | Health Benefits Assoc - AXA | HBA |
| HB | M11 | Health Bonus | |
| HCI | M21 | Health Care Insurance | |
| HP | M44 | Health Partners | |
| HEA | M63 | Health.com.au | |
| HHB | M22 | Healthguard Health Benefits | HHBM |
| HCF | M52 | Hospital Contribution Fund/Health Care Fund | HCFM |
| LHM | M31 | Lysaght & Peoplecare Health Insurance | LHMCM/HFLYS |
| MBF | M01 | Medical Benefits Fund | MBF |
| MMH | M13 | Mutual Health/Mercantile Mutual Health | |
| NRMA | M40 | NRMA Health | NRM |
| NSWTF | M34 | NSW Teachers Federation Health | NTF/TFH |
| NAVY | M33 | Navy Health | NHB-NHBS |
| OMF | M54 | Onemedifund | OMF |
| PWA | M35 | Phoenix Health Fund/Phoenix Welfare | HFPHF |
| POL | M43 | Police Health/South Australian Police Health | SPE-SAP/SAPEH |
| QHC | M23 | Q Health Cover | QHC |
| QCH | M36 | Queensland Country Health | QCHM-MIM |
| RTE | M39 | Railway & Transport Employees | RTEFS/RTE |
| RBHF | M38 | Reserve Bank Health Fund | |
| SLM | M61 | St Lukes Health | |
| TUH | M37 | Teachers Union Health | QTU |
| DHF | M55 | The Doctor's Health Fund | DHFM |
| TFS | M45 | Transport Health/Transport Friendly Society | |
| WDH | M56 | Westfund | HFWF |
Private health funds with no agreement & health fund unknown
| Bill to | A/C Class | Private health fund | Codes hospitals may use |
|---|---|---|---|
| Patient | NIB | NIB | NIB IOOF Health Victoria IOOF NSW & WA |
| Patient | GMH | GMHBA (Geelong Medical & Hospital Benefits Assoc) | GMHBA Frank Insurance (FRA) |
| Patient | LAT | Latrobe | LAT |
| Patient | UNF | Unknown Health Fund | |
| MBP | M02 | Medibank Private | MBP, MPL |
| AHM | M07 | Australian Health Management | AHMG-AHSA Australian Country Health Gov Employees Health Fund [GEF] Australian Union Health Illawarra Health Fund ACH - Australian Country Health Senior Advantage |