Private health insurer registrations and updates for ECLIPSE form (HW081)

Use this form to register and update private health insurer details for the ECLIPSE Electronic Data Interchange and Manual.

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.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 9 April 2018

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