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ECLIPSE

ECLIPSE is an extension to Medicare Australia's online claiming solutions and

  • offers a secure connection between practices, public and private hospitals, billing agents, Medicare and Department of Veterans' Affairs and health funds.
  • incorporates direct communication for providers with Medicare and health funds, all in the one transaction.

Online claiming can be used for both paid and unpaid medical claims— they are lodged directly to Medicare through the practice management software.

The name ECLIPSE is an industry coined acronym, and stands for: Electronic Claim Lodgment and Information Processing Service Environment

Note:

A transitional support package comprises a range of incentives for general practitioners, specialists, pathologists and software vendors to support the take up of electronic claiming.

Features

  1. Online patient verification (OPV)
    Check the validity of patient details with Medicare or a health fund. This can be done in real time and allows for the provision of aliases which cuts down on mismatches.
  2. In-patient medical claiming (IMC)
    • submit an in-patient medical claim to both Medicare and the health fund with a single click
    • fewer errors and fast return of incorrect Medicare details
    • available for all claims made under schemes and agreements, and those not made under a scheme or agreement
    • improved processing times—from weeks to days.
  3. Online eligibility checking
    • check the eligibility of a patient for both Medicare and health fund benefits
    • estimate the out-of-pocket costs for hospital services and any known medical gaps
    • obtain informed financial consent.
  4. ECLIPSE remittance advice
    Match your ECLIPSE claims to the deposits made into your bank accounts allowing for automated reconciliation.
  5. Claim status
    Check the status of an in-patient medical claim at any time. You will always have a clear view of where your claim is up to in the process.
  6. Online security
    Everyone—patients and staff—can feel confident that all information is transmitted securely using public key infrastructure (PKI) encryption.

What are the benefits?

  • Faster resolution of claims and faster payment times
  • Less manual intervention - fewer errors, speedier resolutions
  • Clearer error messages with a single point of contact for problem resolution
  • Online patient verification of Medicare enrolment and health fund membership
  • No more claims batching
  • One system for all health funds
  • No transaction costs for medical claiming
  • A one stop shop for claiming

What health funds are involved?

All health funds are committed to the development of ECLIPSE.

Currently doing business online with Medicare Australia are:

  • Australian Unity
  • ACA Health Benefits
  • BUPA Australia trading as:
    • ANZ Health Insurance
    • Card Member Health Insurance
    • CSR Health Plan
    • HBA
    • Health Cover Direct
    • Mutual Community
    • St George
    • Super Members Health Plan
    • Territory Mutual
  • CBHS
  • Central West Health
  • Cessnock District Health
  • Credicare
  • CY Health
  • Defence Health
  • Druids Friendly Society
  • GMF Health
  • GMHBA
  • HCF Health Insurance
  • Health Care Insurance
  • Health Partners
  • Latrobe Health Services
  • Lysaght Peoplecare
  • Manchester Unity
  • MBF (Online Patient Verification – OPV only)
  • Medibank Private (Online Patient Verification - OPV and Patient Claims - IMC PC only)
  • Mildura District Hospital Fund
  • Navy Health
  • Phoenix Health
  • Queensland Country Health
  • Railway and Transport Health Fund  (Online Patient Verification – OPV only)
  • Reserve Bank Health Society
  • St Lukes Health
  • Teachers Federation Health
  • The Doctors' Health Fund

How are hospitals involved?

Depending upon the option that your business chooses, a hospital may operate as a billing agent or under an agreement.

Find more information on how to register as a billing agent.

Hospitals have now commenced integrating ECLIPSE into their systems.

Comments from practices

During June 2005 Medicare Australia contacted a selection of practices using our online services:

'I'd heard that the online claiming could improve cash flow and it has proved that, it does help,' Group practice manager Fay Briggs, Hahndorf, Mount Barker, Woodside and Nairne Medical Practices June 2005.

'The program itself takes you through everything step-by-step and it's just really easy.' Practice Manager Pat Deegan, Mountain Retreat Medical Practice June 2005.

'The claims are coming back quicker and they're coming back with less rejections. The program is explaining exactly why they've been rejected. And they're easier to resubmit because we can resubmit them online straight way.' Practice Manager, Ms Wootton, M Catt Pty Ltd June 2005.

Contact us

For further information on ECLIPSE:

For ECLIPSE technical support:

Make a request for more information, or to have a business development officer contact your practice.

Last updated: 19 August, 2008

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