Simplified Billing and ECLIPSE

Simplified Billing aims to reduce the number of accounts a private patient receives after being in hospital. ECLIPSE is an extension of Medicare Online claiming.

About

Simplified Billing

Simplified Billing aims to reduce the number of accounts a private patient receives after being in hospital. It's an initiative of the Australian Government Department of Health.

We have streamlined the way patients pay their bills and claim benefits from Medicare and their private health insurer.

ECLIPSE

Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE) is an extension of Medicare Online claiming. It offers a secure connection between:

  • health professionals
  • public and private hospitals
  • billing agents
  • private health insurers
  • the Department of Veterans' Affairs
  • us

It includes direct communication in the one transaction between health professionals, us and private health insurers.

ECLIPSE can be used for both paid and unpaid in patient medical claims and can be lodged directly with us through practice management software. ECLIPSE can also be used to lodge in hospital claims from public and private hospitals and day facilities in relation to the patient's hospital stay. This includes claims for accommodation, transfers, and miscellaneous items like prosthetics.

Read the ECLIPSE Online Hospital Claiming User Guide for more information.

Medical and eligibility user guide for medical practitioners

Some of the benefits of using ECLIPSE include:

  • faster resolution of claims
  • less manual intervention - fewer errors, quicker resolutions
  • clearer error messages with a single point of contact for fixing problems
  • online patient verification of Medicare enrolment and private health insurer membership
  • no more claims batching
  • 1 system for all private health insurers
  • no transaction costs for medical claiming
  • all-in-1 area for claiming
  • overseas claiming
  • online eligibility check of the patient's status with Medicare and their private health insurer and to obtain an estimate of out-of-pocket expenses

Refer to the Medical and Eligibility User Guide for Medical Practitioners - ECLIPSE for further information.

Register

ECLIPSE

Information about registering for Medicare Online and ECLIPSE to lodge electronic claims:

  1. apply for a Medicare PKI Site Certificate
  2. check with your software vendor that your software is compatible
  3. register for online claiming
  4. submit online claiming provider agreement form
  5. submit the form for approval
  6. use the registration checklist

ECLIPSE

Billing Agent

Individuals or companies wishing to register as a Billing Agent need to:

  1. fill in an Application to register as an Approved Billing Agent and ECLIPSE form
  2. complete and sign a statutory declaration
  3. complete and sign a deed poll in favour of us - 2 copies required
  4. include an application fee
  5. submit the form for approval
  6. use the registration application checklist

Billing Agent

Managing

Medicare digital claiming return codes

When you lodge a claim for Medicare benefits, we use return codes to tell you why the claim was rejected or how the claim was assessed.

Read more about Medicare digital claiming return codes

Resources

Simplified Billing and ECLIPSE forms

Use the Simplified Billing or ECLIPSE adjustment form to request a latter day adjustment to a Simplified Billing or ECLIPSE claim.

Use the Hospital or Day Procedure Centre Registration for In Hospital Claiming form to register a hospital a day procedure centre for In Hospital claiming.

Use the Application for late lodgement of a Simplified Billing claim for assigned Medicare benefits form to apply for the lodgement of a Simplified Billing claim for assigned Medicare benefits, which must be submitted to us through a nominated private health insurer or Billing Agent.

Approved Billing Agents

A list of approved Billing Agents and their details.

Read more about Approved Billing Agents

Private Health Insurers’ functionality and contact details

The functionality and contact details of each private health insurer using ECLIPSE.

Read more about health fund functionality and contact details

Page last updated: 13 October 2017