Claiming choices for health professionals

Compare the different claiming options available and work out which is the right one for you and your patients.

What you need to know

The claiming channel you choose can make a big difference to productivity, cash flow and patient service. The benefits to using electronic claiming include:

  • less paperwork
  • faster payment
  • streamlined billing processes
  • increased cash flow
  • automatic eligibility to the 90-day pay doctor cheque scheme
  • greater patient satisfaction

We understand that you all have different needs. This is why we offer more ways to make claims. The options include:

How different channels compare

Medicare Online

Medicare Online supports bulk bill and patient claiming, as well as Department of Veterans' Affairs claims and the transfer of Australian Childhood Immunisation Register data.

Your practice management software allows you to lodge your patient claims via a secure internet connection. You can find out if online claiming functions are integrated into your vendor's software.

Many of your patients will usually receive their benefit the next working day.

Medicare Easyclaim

Medicare Easyclaim is used for Medicare bulk billing and patient claiming. It can be a stand-alone process via an EFTPOS device, or an integrated feature of some practice management software products.

If you're using Medicare Easyclaim for patient claims, you can start claiming once your EFTPOS provider installs it. For bulk billing, you need to register your bank account details first.

Medicare Easyclaim is simple to adopt, requires minimal training and is easy to use. You can use it 24 hours a day, 7 days a week. Your patients will receive their benefit almost immediately after swiping their EFTPOS card.

ECLIPSE

Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE) is an extension of Medicare Online claiming. ECLIPSE provides a secure connection between health professionals, public and private hospitals, private health insurers, billing agents, Department of Veterans' Affairs and us.

Features include:

  • one process for all private health insurers
  • an easier way to obtain informed financial consent from patients
  • paperless business transactions
  • quicker processing times
  • better data quality, leading to fewer errors and speedier resolution

ECLIPSE also lets private hospital patients:

  • pay only the gap, and
  • claim benefits from Human Services, their private health insurer and Department of Veterans' Affairs

Help your patients claim on the spot at your practice

If you already use Medicare Online, it's easy to 'switch on' patient claiming. To find out more, contact your software vendor or contact us to talk to one of our Business Development Officers.

If you're using Medicare Online for patient claiming, you don't have to ask patients for their bank account details. Patients register their bank details with us. Medicare Online lets you submit patient claims even if you don't have the patient's bank account details.

Electronic patient claiming

Instead of completing a form, you can use Medicare Online to send patient claim information directly to us through a secure internet connection. Benefits are paid directly into the patient's nominated cheque or savings account, usually the next working day. If the claim information is sent using Medicare Easyclaim, patient benefits are paid directly into the patient's nominated cheque or savings account almost immediately.

Contact us

To register for electronic claiming, or for more information about the best claiming options for your practice, contact us and arrange to speak to a Business Development Officer.

This information was printed from humanservices.gov.au It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.