Pathology Billing

Male scientist looking in a microscope while his female colleague is taking notes.

Hosted on StaffLink, eHealth NSW’s Pathology Billing solution is used by NSW Health Pathology (NSWHP). It is a single, state-wide billing, claiming and revenue collection solution designed to meet NSWHP’s specific requirements.

Female clinician working in the laboratory using a microscope.

The Challenge

Historically, NSW Health Pathology had been operating with four individual billing and claiming systems. Some of these systems were reaching end of life, had limited integration and didn’t support NSWHP’s vision of a consistent approach to pathology services across NSW Health.

eHealth NSW was asked to work with NSWHP to provide a solution that streamlined and standardised their complex billing and claiming processes.

Male scientist looking into microscope in laboratory.

The Plan

The plan was for eHealth NSW to replace these four individual systems with a single, statewide solution that leveraged the latest in digital innovation.

This major program of work involved complying with some of the most complex billing and claiming rules in the Australian business environment. It also needed to meet the needs of NSWHP’s partners, Medicare Australia, the Department of Veteran Affairs and private health funds.

No ‘off the shelf’ products catered directly to NSWHP’s strict requirements without requiring extensive customisation. Opting to extend the already existing Oracle E-Business suite, StaffLink, eHealth NSW created a number of pathology billing specific enhancements to ensure the new product met business and user needs, integrated with other StaffLink modules (e.g. accounts receivable, general ledger, and interhealth billing) and could be easily configured in the future.

Male and female pharmacist examining liquid sample.

The Outcome

To date, the new pathology billing system has been implemented at three of five operational areas which service 165 hospitals and facilities.

It will eventually be rolled out to the remaining NSWHP operational areas, which service 274 hospitals, aged care facilities and other health entities.

Clinician working in the laboratory using a microscope.

The Benefits

Enhanced reporting – state-wide dashboards provide greater transparency supporting more informed decision making
Consistent, accurate billing - delivering increased revenue recovery
Process improvements – the solution streamlined and consolidated business rules and processes statewide
Automated workflows – less manual administrative work for staff
Performance improvements – reduction in revenue leakage due to more efficient processes
Future-proofed – building the solution on the latest technology means future requirements will be easier to implement.

Key Stats

180

different health sites have had transactions processed

463,000+

bills processed each month

130,000+

invoices processed each month

out of 5 operational areas now live on the system

Data correct as of October 2023