Simplified Billing
You can use Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE) to submit Simplified Billing claims.
Simplified Billing reduces the number of accounts a private patient gets after being in hospital.
Hospitals or billing agents can submit claims on behalf of the provider to get both the Medicare benefit and private health insurer gap payment.
Simplified Billing means your patient only pays one out-of-pocket expense to the provider.
Patient claims for in-patient services
You can also use ECLIPSE for patient claims for in-patient services.
ECLIPSE streamlines the way patients pay their bills, claim Medicare benefits and claim from their private health insurer.
Forms and resources
Private health insurers or billing agents complete the:
- Simplified Billing or ECLIPSE adjustment form (HW023) to request a latter-day adjustment to a Simplified Billing or ECLIPSE claim
- Application for late lodgement of a Simplified Billing claim for assigned Medicare benefits form (HW026) to apply for the lodgement of a Simplified Billing claim for assigned Medicare benefits over 2 years from the date of service
- Simplified Billing manual claims batch header form (HW091) to submit manual Simplified Billing claims.
Private health insurers complete the Private health insurer registrations and updates for ECLIPSE form (HW081) to either:
- register and update your private health insurer details for ECLIPSE, Electronic Data Interchange and manual claiming
- add or remove ECLIPSE functionality.