Simplified Billing or ECLIPSE adjustment claim form (HW023)

Medical practices, providers, private health insurers and billing agents should use this form when an adjustment is required to a previously processed claim which needs to be amended with new or altered information.


Page last updated: 14 September 2016

This information was printed Wednesday 28 September 2016 from It may not include all of the relevant information on this topic. Please consider any relevant site notices at when using this material.