In-Patient Medical Billing

In-Patient Medical Billing

If you wish to transmit your inpatient medical claim via ECLIPSE, you will need to ensure that you have billed correctly and included all the relevant information. This support sheet will walk you step by step through the process of ensuring you have added all the correct information to patient details, as well as created the invoice correctly.

Search Existing Patient or Add New Patient

Review Patient Details support sheet if needed and open Patient Details

Online Patient Verification [Mandatory for IMC Billing]

Cards Tab

Medicare Card
  1. Select PVM Option.
  2. Enter Earliest Date of Service. 
  3. If card is ELIGIBLE no further action is required.
  4. 8005 code returned then do PVM again and card will be ELIGIBLE.
Health Fund Card
  1. Select PVF Option.
  2. Enter Earliest Date of Service. 
  3. If card is ELIGIBLE no further action is required.
Referral Tab
  1. Patient must have a valid Referral for the Admission or enter Referral Details

Admission Tab
  1. Click Add Button [left hand side of screen]
  2. Click the Add + button in the Admissions window.
  3. Select the required Location and Provider codes.
  4. Select Fund
  5. Select Admission date. This can be a service within 2 years of the current date.
  6. Select Earliest Date of Service [Admission Date]
  7. Select Informed Consent option
  8. Click the Save √ button to save or Cancel to abort and start again.
  9. Select the OPV button [ MUST BE ELIGIBLE or do PVM and PVF]
  10. Click the Close button to return to the PATIENT DETAILS window.

In-Patient Medical Claim Billing

From Patient Details : Click F8
 
  1. Tick Option Invoice For IMC
  2. Loc:      Select Hospital Location
  3. Prov:    Select Provider
  4. Select Service date.   Must not be older than 2 years.
  5. F Type: IMC or MS if billing Medicare Schedule Fee only for service
  6. Select Fund B. ID [Health Fund]
  7. Select Item code:
  8. Tab. Health Fund Fee will populate if IMC fee type selected. MS fee will populate if MS fee type selected.
  9. Referral Details: Auto-populates for Specialist Provider if only one Referral for patient. 
  10. If it does not populate double click in Referral Details box, 
  11. Select Referral from list and click OK 
  12. Or Click Add to add Referral. 
  13. Complete Referral details
  14. Then select and Click OK.
  15. Select Patient Admission
  16. Down arrow to add further service line items or click New Row at bottom of screen
  17. Print: will print and auto save [Bottom of screen in Invoice and Payment].
  18. Save will send service item to Medicare module without printing.
Voucher is now in The Medicare Claims\000\ Unprocessed view waiting batching and Transmission to Medicare Australia