Education guide - Registering for Medicare Online and ECLIPSE claiming

Information about registering for Medicare Online and ECLIPSE to submit electronic claims directly to us through your practice management software.

Registering for Medicare Online

Complete these steps to register for Medicare Online and submit claims from any site that has online claiming enabled through your practice management software:

  1. Check with your software vendor, if your software and operating system is compatible.
  2. You need a Medicare Public Key Infrastructure (PKI) site certificate.
  3. You must register for online claiming.

Check your practice management software

Your software product must be approved by us to support Medicare Online claiming. For example to:

  • submit different types of claims:
    • bulk bill claims
    • patient claims
    • Department of Veterans' Affairs (DVA) claims
  • send Australian Immunisation Register (AIR) data (notification of immunisation)
  • complete:
    • Online Patient Verification (OPV)
    • Online Concession Entitlement Verification (OCV)

Apply for a Medicare PKI site certificate

You need a Medicare Public Key Infrastructure (PKI) site certificate as:

  • a Medicare PKI site certificate allows you to securely do your electronic business with us
  • some practice management software security signing options require you to sign transmissions with a Medicare PKI individual certificate. If required, you will also need to register for a Medicare PKI individual certificate

Complete an Online Claiming Provider Agreement

You only need to register once by completing 1 agreement.

Once registered, you can submit any type of online transmission from any location (site) that has online solutions.

The Online Claiming Provider Agreement form (HW027) also includes registering your bank details for Electronic Funds Transfer (EFT) payments. You only need to complete 1 agreement, however you must provide bank details for each practice location. For other locations, use the Banking Details - Online Claiming form (HW052).

You can contact the eBusiness Service Centre and arrange to speak to a Business Development Officer about your specific business needs.

Functionality may vary between software products. You can research the capability of software products, before engaging a software vendor.

For information on software vendors offering online claiming functions available in software go to Vendors offering Medicare online claiming.

Applying for a Medicare PKI site certificate

You need to complete, print, sign and return the Application for a Public Key Infrastructure Site Certificate form (HW001).

If you haven't previously:

  • established a relationship with us as a registered health professional, or
  • registered with us as a business

Then you must provide certified copies of Evidence of Identity (EOI) documents:

  • Individuals – 100 points of EOI
  • Businesses – one of the listed EOI documents

Refer to the EOI documents listed in the application form complete the Acceptable Referee Declaration Public Key Infrastructure Certificate applications form (HW004).

Registering for online claiming

Complete, print, sign and return the Online Claiming Provider Agreement form (HW027) includes registering bank details.

For subsequent practice locations you must complete the Banking Details – Online Claiming form (HW052).

If registering on behalf of health professionals in your practice, make sure you have their consent as:

  • we require consent to access Medicare records
  • health professionals must sign the relevant online agreement

Before you submit online claims

This preparation checklist supports you to successfully connect online to us for online claiming.

Check you have:

  • internet connection
  • applied for a Medicare PKI site certificate
  • registered for your Medicare PKI individual certificate, if your practice software requires you to sign transmissions with a Medicare PKI individual certificate
  • a Medicare PKI site certificate CD kept in a known place ready for installation, if not already installed
  • a personal identification code (PIC) for your Medicare PKI site certificate
  • kept your original PIC in case you need to re-enter this information
  • completed the Online Claiming Provider Agreement form (HW027) so you are registered to do business online, includes banking details

Check with your software vendor if:

  • your computer operating system is compatible with doing business online with us
  • your practice management software has all the functionalities you need for Medicare Online

This includes:

  • bulk bill
  • patient claims
  • DVA claims
  • AIR

Keeping online claiming details up-to-date

Online claiming registration

Once registered for online claiming, it is important you contact us about changes to your online claiming registration details, for example your phone number, mailing address, or change in business ownership.

You can update changes to bank account details through Health Professional Online Services (HPOS) or update and return the Banking Details – Online Claiming form (HW052) to us.

To advise of changes, contact the eBusiness Service Centre.

Medicare PKI site certificate

Duly Authorised Officer (DAO) must inform our eBusiness Service Centre of changes to:

  • the Location ID
  • the PKI Registration Authority (RA) number or
  • other relevant information

DAOs are also responsible for managing the Medicare PKI site certificate revoking, reissuing and renewing.

Registering for ECLIPSE

ECLIPSE is an extension of the Medicare Online claiming solution and is used to submit claims directly to us and private health insurers in the 1 transaction.

Practices must be registered for online claiming before they can use ECLIPSE because of its dependence on Medicare Online technology. Refer to Registering for online claiming.

You need to complete these steps to register for ECLIPSE:

  1. Check with your software vendor, if your software and operating system is compatible
  2. You need a Medicare Public Key Infrastructure (PKI) site certificate
  3. You must register for the appropriate type of organisation

Check your practice management software

Your software product must be approved by us and support the functions required for ECLIPSE claiming. For example to:

  • submit different types of claims:
    • In-patient Medical Claims (IMC)
    • In-Hospital Claims (IHC)
    • In-Hospital Claims DVA
    • Overseas claims (OVS)
  • complete:
    • Online Patient Verification (OPV)
    • Online Concession Entitlement Verification (OCV)

Apply for a Medicare PKI site certificate - only if you do not already have one

A Medicare PKI site certificate allows you to securely do your electronic business with us.

You should already have a Medicare PKI site certificate installed if you are using Medicare Online.

Some practice management software security signing options require you to sign transmissions with a Medicare PKI individual certificate.

If required, you will also need to register for a Medicare PKI individual certificate.

Register as a hospital or day procedure centre or an approved billing agent

We make ECLIPSE payments to private health insurers or billing agents via electronic funds transfer (EFT) who then forward the Medicare benefit on to you. You must register your banking details with private health insurers or billing agents.

Approved billing agents must register for online functionality with private health insurers to transmit claims to them.

You can contact the eBusiness Service Centre and arrange to speak to a Business Development Officer about your specific business needs.

Functionality may vary between software products. You can research the capability of software products, before engaging a software vendor.

Read more about Simplified Billing and ECLIPSE.

Read more about applying for a Medicare PKI certificate.

Registering a hospital or day procedure centre for In-Hospital Claiming (IHC)

You need to complete, print, sign and return the Hospital or Day Procedure Centre Registration for In-Hospital Claiming form (HW025).

If you have not previously registered with us as a health professional then you must also:

Registering as an Approved Billing Agent for ECLIPSE

Individuals or companies establishing a billing agency need to complete Billing Agent registration.

Keeping details up-to-date

Medicare PKI site certificate

Duly Authorised Officer (DAO) must inform our eBusiness Service Centre of changes to:

  • the Location ID
  • the PKI Registration Authority (RA) number or
  • other relevant information

DAOs are also responsible for managing the Medicare PKI site certificate revoking, reissuing and renewing.

Before you submit ECLIPSE claims

This preparation checklist supports you to successfully connect online to us and health insurers for ECLIPSE claiming.

Check you have:

  • internet connection
  • applied for a Medicare PKI site certificate
  • registered for your Medicare PKI individual certificate, if your practice software requires you to sign transmissions with a Medicare PKI individual certificate
  • a Medicare PKI site certificate CD kept in a known place ready for installation (if not already installed)
  • a personal identification code (PIC) for your Medicare PKI site certificate
  • kept your original PIC in case you need to re-enter this information
  • completed the relevant registration forms as a:
  • registered your banking details with private health insurers or billing agents
  • clarified if:
    • your ECLIPSE claims need to be submitted as Schemes or Agreements
    • you will need to quote a fund payee ID
  • additional note for approved billing agents
  • registered for online functionality with the private health insurers that you'll be transmitting data to

Check with your software vendor if:

  • your computer operating system is compatible with doing business online with us
  • your practice management software has the ECLIPSE enabled functionalities you need, such as In-patient Medical Claims and In-Hospital Claims

Contact details for services

Service Contact
Software vendors offering Medicare Online and ECLIPSE Online: Vendors offering Medicare online claiming
PKI Online: Public Key Infrastructure
Phone: eBusiness Service Centre for help in completing the forms
Email: registration@humanservices.gov.au

Registering for online claiming

Enquiries about online claiming

Online: Register for online business
Phone: eBusiness Service Centre for help in completing the online claiming registration and enquiries, including:
  • registration
  • business support
  • on-site visits
  • help with the transmission process
  • changed contact or practice details
  • technical problems with missing claims, confirmation of transmissions

Email: ebusiness@humanservices.gov.au

ECLIPSE Medical and Eligibility User Guide

Private health insurer's functionality and contact details

Simplified Billing and ECLIPSE forms

Online: Simplified Billing and ECLIPSE
Phone: eBusiness Service Centre for help in completing the forms
Billing Agent and ECLIPSE registering Online: Simplified Billing and ECLIPSE
Email: simplified.billing@humanservices.gov.au
Access to the Doing Business with Medicare Electronically eLearning program and other online education resources Online: Education services for health professionals

Read more information about our website disclaimer.

Page last updated: 30 September 2016

This information was printed Saturday 10 December 2016 from humanservices.gov.au/health-professionals/enablers/education-guide-registering-medicare-online-and-eclipse-claiming 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.