Add an Admission

Add an Admission

To transmit an inpatient medical claim (via ECLIPSE) you need to add the admission details for the service provided. This allows the health fund to quickly match your service against an admission which has been submitted by the hospital. This support sheet will walk you through step by step to add an admission for a patient.


Before you start

  1. Admissions are entered on the PATIENT DETAILS window.
  2. In-Patient Medical Claims (ECLIPSE) require an Admission to be set for the Patient 
  3. An OPV must be done for that Admission to ensure that both the Patients Medicare Card and Health Fund Card is ELIGIBLE
  4. Earliest date of Service is the Admission Date
  5. Any code other than “Eligible” must have an immediate follow-up OPV done to ensure that the new details if any received via the Medicare portal is saved and sent for Patient verification. 
  6. Where an OPV does not return an eligible status in the Admissions screen, return to Patient Details Screen.
  7. A PVM must be done first for the Admission date [Earliest date of Service] and return ELIGIBLE
  8. Then a PVF must be done and Return ELIGIBLE for the Admission date. 
  9. The claim Type [AG, SC, PC] determines the processing class under which a claim is submitted. 
  10. Informed Financial consent must be set for each episode of care. 
  11. AG: Agreed fund arrangements must be either Verbal, Written or Not obtained
  12. SC: Scheme Fund arrangements Must be either Written or Not obtained
  13. PC: IMC Patient Claim is selected where an In-Patient Medical Claim, Patient Claim is transmitted for and on behalf of the patient.
  14. Fund Arrangements for the Location Provider if not set prior to Admission being entered can be set from the Admissions screen
  15. It is advisable that an admission linked to a claim transmitted to Medicare Australia should not be edited unless the claim was rejected and the data entered is incorrect

Add an Admission

  1. Click the Admissions tab in Patient Details
  2. Click the Add button.
  3. Click the Add + button in the Admissions window.
  4. Select the required Location and Provider codes.
  5. Select Fund
  6. Select Admission date. This can be a service within 2 years of the current date.
  7. Select Earliest Date of Service [Admission Date]
  8. Select Informed Consent option
  9. Click the Save √ button to save or Cancel to abort and start again.
  10. Select the OPV button [ MUST BE ELIGIBLE- see note above if not]
  11. Click the Close button to return to the PATIENT DETAILS window.

Edit an Existing Admission

  1. In the Admissions Screen Click on the row in the Admissions grid that displays the Admission you wish to edit.
  2. Click the Edit button [triangle].
  3. Edit the Admission.
  4. Click the Save √  button or Cancel to abort.
  5. Click the Close button to return to the PATIENT DETAILS window.

Add a Fund Arrangement

  1. This option is available where the fund arrangement is not in the Fund drop down list for the Admission for the Location Provider
  2. Add the Admission as above and save without selecting a Fund
  3. make sure the cursor is on the Admission listed in the bottom half of the screen you wish to add a fund Arrangement for
  4. Click Fund arrangement button
  5. Click the Add + button and select the fund from the drop down list
  6. Complete the Fund Payee ID
  7. Select the Claim type
  8. Click save√ button
  9. Close the Set Up Provider Fund Arrangements screen
  10. Click Edit on the Admission and select the fund from the Drop down list
  11. Save
  12. Select the OPV button
  13. Click the Close button to return to the PATIENT DETAILS window.


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