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 Lodgement 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.

ECLIPSE is the Electronic Claim Lodgement and Information Processing Service Environment.

 
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
This information was printed Tuesday 21 May 2019 from https://www.humanservices.gov.au/organisations/health-professionals/forms/hw015 It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.humanservices.gov.au/individuals/site-notices when using this material.

Page last updated: 26 November 2018