Simplified billing and ECLIPSE

Simplified billing aims to reduce the number of accounts a private patient receives after being in hospital. Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE) is an extension of Medicare Online claiming.

Simplified billing

Simplified billing aims to reduce the number of accounts a private patient receives after being in hospital. It is an initiative of the Australian Government Department of Health.

Along with private health insurers and billing agents, usually a hospital or day surgery centre, we have streamlined the way patients pay their bills, claim benefits from Medicare and their private health insurer. This allows patients to concentrate on improving their health or recuperating.

ECLIPSE

Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE) is an extension of Medicare Online claiming. It offers a secure connection between health professionals, public and private hospitals, billing agents, health professionals, private health insurers, the Department of Veterans' Affairs and us. It includes direct communication between health professionals with us and private health insurers in the 1 transaction.

ECLIPSE can be used for both paid and unpaid In-patient Medical Claims which can be lodged directly with us through practice management software.  ECLIPSE can also be used to lodge In-Hospital Claims from public and private hospitals and day facilities in relation to the patient's hospital stay. This includes claims for accommodation, transfers, and miscellaneous items like prosthetics.

ECLIPSE medical and eligibility user guide

Some of the benefits of using ECLIPSE include:

  • faster resolution of claims
  • less manual intervention - fewer errors, quicker resolutions
  • clearer error messages with a single point of contact for fixing problems
  • online patient verification of Medicare enrolment and private health insurer membership
  • no more claims batching
  • 1 system for all private health insurers
  • no transaction costs for medical claiming
  • all-in-1 area for claiming
  • overseas claiming
  • online eligibility check of the patient's status with Medicare and their private health insurer and to obtain an estimate of out-of-pocket expenses

Refer to the Medical and Eligibility User Guide for Medical Practitioners - ECLIPSE (9173) [rtf, 1.0mb] for further information.

Private health insurers involved

For the health fund functionality and contact details of each private health insurer involved in ECLIPSE, refer to the Health Fund Functionality and Contact Details [rtf, 591kb].

Simplified billing and ECLIPSE forms

Use the Simplified Billing or ECLIPSE adjustment form (HW023) to request a latter day adjustment to a simplified billing or ECLIPSE claim.

Use the Hospital or Day Procedure Centre Registration for In-Hospital Claiming form (HW025) to register a hospital a day procedure centre for In-Hospital claiming.

Use the Application for late lodgement of a simplified billing claim for assigned Medicare benefits form (HW026) to apply for the lodgement of a simplified billing claim for assigned Medicare benefits, which must be submitted to us through a nominated private health insurer or billing agent.

Billing agent

Under legislation, we are required to consider applications for registration as a simplified billing agent and we are also responsible for auditing them.

A billing agent must be approved by us. It can be a corporation, partnership, individual or body.

Approved billing agent

Billing agents act on the patient's behalf to claim Medicare and private health insurance medical benefits. The patient does not need to be involved, unless there is an agreed out-of-pocket expense.

Billing agents are entitled to collect the gap benefit from the private health insurer, on behalf of the provider, when the private health insurer and health professional have a gap cover scheme arrangement.

Billing agent registration

Individuals or companies wishing to establish a billing agency need to download the Billing Agent Registration Kit. For more information, contact us.

Billing agent registration kit

The Billing Agent Registration Kit includes:

  • an application to register as an approved billing agent and ECLIPSE form
  • statutory declaration
  • a deed poll in favour of us (2 copies required; you retain 1 copy)
  • deed poll instructions
  • a billing agent registration checklist

Approved billing agents

Simplified Billing Agents List - October 2014

Registration
Number
Name of AgentTrading NameContactPhoneAddress
3530120HWestern Sydney Local Health DistrictWestern Sydney Local Health DistrictRosemary Vella02 9845 6413PO Box 119
Wentworthville NSW 2145
3530170XIntensive Care Academic Fund IncMedical Billing SerViceRobert Murton03 8379 3501Locked Bag 820
Carlton South Vic 3053
3530180WHunter New England Local Health NetworkHunter New England Local Health NetworkFiona Maughan02 4985 3356Simplified Billing
Locked Bag No.1
Hunter Region Mail Centre
NSW 2310
3530220BSt Luke's CareSt Luke's CareMaya Taher02 9356 0404PO Box 35
Potts Point NSW 2011
3530260WAlbury Aggregate Medical Billing Co Pty LtdAlbury Aggregate Medical Billing Co Pty LtdAnn McHardy02 6041 1511PO Box 970
Albury NSW 2640
3530450KSouth Eastern Sydney Local Health DistrictIllawarra OneBillDebbie Nevin02 4275 5131Private Mail Bag No 3
Port Kembla NSW 2505
3530470HMontserrat Pty LtdMontserrat Day HospitalPrea Pillay07 3833 6738Mailbox 16
527 Gregory Terrace
Bowen Hills Qld 4006
3530500WAlpine HealthAlpine HealthCraig Thompson03 5751 9347PO Box 23
Myrtleford Vic 3737
3530550H
3531300W
Sydney Local Health DistrictSydney Local Health DistrictStephen Carr02 9515 9120Locked Bag 21
Camperdown NSW 2050
3530560F
3531160L
The Sydney Children's Hospitals Network
(Randwick and Westmead)
The Children's Hospital at WestmeadKim Webster02 9845 3657Locked Bag 4002
Westmead NSW  2145
353130TSouth Western Sydney Local Health DistrictSouth Western Sydney Local Health DistrictVeeda Nelson 02 9828 5737SWSLHD Revenue Departement
Locked Bag 7110
Liverpool Retail NSW 1871
3530580ACentral Coast Local Health DistrictCentral Coast Local Health DistrictKim Green02 4320 3239Finance Officer
Locked Bag 50
Gosford NSW 2251
3530610KMurrumbidgee Local Health NetworkMurrumbidgee Local Health NetworkCathy Barnett02 5908 4100Finance Division
PO Box 1015
Wagga Wagga NSW 2650
3530630HThe Canberra HospitalThe Canberra HospitalStephen McPherson/Leo De Boer02 6205 1483PO Box 11
Woden ACT 2606
3530640FYarrawonga District Health SerViceYarrawonga District Health SerViceMelissa Murfitt03 5743 811133 Piper Street
    Yarrawonga Vic 3730
3530690WStawell Regional HealthCentral Grampians Billing SerViceSandra Dunn03 5358 8504Sloane Street
Stawell Vic 3380
3530700J
3531220W
Northern Sydney Local Health DistrictNorthern Sydney Local Health DistrictRex Byun02 9462 9841Revenue Department
Royal North Shore Hospital
PO Box 100
St Leonards NSW 1590
3530720FCobram District HospitalCobram District HospitalLisa Germani03 5871 077720-24 Broadway Street
Cobram Vic 3644
3530730BThe Kilmore & District HospitalThe Kilmore & District HospitalLynne Warren03 5734 2183PO Box 185
Kilmore Vic 3764
3530740AMansfield District HospitalMansfield District HospitalSharyn Simpkin03 5775 884753 Highett Street
Mansfield Vic 3722
3530760XBenalla and District Memorial HospitalBenalla and District Memorial HospitalIan Hatton03 5760 2222PO Box 406
Benalla Vic 3672
3530770W
3530590Y
3530650B
3531210X
Western NSW Local Health DistrictWestern NSW Local Health DistrictFiona Skaines02 6369 8118Private Bag 6001
Orange NSW 2800
3530810BSwan Hill District HealthSwan Hill District HealthPeta Lindsay03 5033 9223PO Box 483
Swan Hill Vic 3585
3530890JThe Gastrointestinal Centre P/LThe Gastrointestinal Centre P/LKerry Wheeler07 5564 6922PO Box 2050
Southport Qld 4215
3530900ANumurkah District Health SerViceNumurkah District Health SerViceWilliam Hall03 5862 0551PO Box 128
Numurkah Vic 3636
3530960KStreamline Medical Billing Pty LtdStreamline Medical BillingLee-Anne Keen03 5331 6123723 Wilson Street
Ballarat Vic 3350
3531060WSydney Adventist Hospital LtdSydney Adventist Hospital LtdKay Truman02 9487 9109185 Fox Valley Road
Wahroonga NSW 2076
3531070TAlbury Wodonga Health
Wodonga Campus
Albury Wodonga Health - Wodonga CampusPatrea Turton02 6051 745251-81 Vermont Street
Wodonga Vic 3690
3531080LEchuca Regional HealthEchuca Regional HealthTina Cartledge03 5485 587317 Francis Street
Echuca Vic 3564
3531090KRobinvale District Health SerVicesRobinvale District Health SerVicesVicki Shawcross03 5051 8102PO Box 376
Robinvale Vic 3549
3531100BNorthern NSW Local Health DistrictNorth Coast Area Health SerViceMary Peterson02 6620 2154Locked Bag 11
Lismore NSW 2480
3531110ACalvary Health Care (Newcastle) LtdCalvary Mater NewcastleMaylinda Wells02 4014 4721Locked Bag No 7
Hunter Region Mail Centre
NSW 2310
3531120YMonash HealthMonash HealthKelvin Payne03 9594 2528Finance Department Monash Health
246 Clayton Road
Clayton Vic 3168
3531130XSouthern NSW Local Health NetworkSouthern NSW Local Health NetworkApril Schwencke02 5942 3106PO Box 1015
Wagga Wagga NSW 2650
3531170KA2 Medical Billing SerVice Pty LtdA2 Medical Billing SerVice Pty LtdAnne Arklay /
Anne Savage
03 5229 445960 Russell Street
Newtown Vic 3220
3531200YWestern HealthWestern HealthSusan Eade03 8345 6267146-152 Gordon Street
Footscray Vic 3011
3531230TCalvary Health Care ACTCalvary Health Care ACTCatherine Shadbolt02 6201 6464PO Box 254
Jamison Centre ACT 2614
3531250KNepean Blue Mountains Local Health DistrictNepean HospitalJacqueline Worsley02 4734 1503Revenue SerVices Nepean Hospital
PO Box 63
Penrith NSW 2751
3531290BBijib Pty LtdBijib Pty LtdRaghuram (Ram) Garikapati02 9449 276126 Reynolds Street
Pymble NSW 2073
3531340JNSW Health PathologyNSW Health PathologyTerrie Bevan02 4920 4028PO Box 846
Newcastle NSW 2300