Application to register as an Approved Billing Agent and ECLIPSE form (HW015)

Use this form to register as an Approved Billing Agent, and to participate in Electronic Claim Lodgment and Information Processing Service Environment (ECLIPSE).

You must submit this form with all of the required documents as outlined in the billing agent registration process.

Page last updated: 5 February 2016

This information was printed Wednesday 28 September 2016 from humanservices.gov.au/health-professionals/forms/hw015 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.