Brief Overview

Clinic to Cloud would like to introduce a streamlined approach to manage and claim Bulk Bill, DVA and Health Fund invoices. 

The option to create a Exception or Rejected claim from the Exceptions tab found in Claiming.

When an invoice is complete and it is time to claim, a Submit option will mark this invoice with a Ready status to be automatically claimed at 1:00am AEST daily. 

A response will be available after each invoice is transmitted to Medicare/ECLIPSE

The Short Version

• The Exceptions tab is available to manage claims with Medicare/ECLIPSE errors, rejections or part payments.
• Exception or Rejected claims are available with error codes and details from Medicare/ECLIPSE
• Edit allows the option to edit items with zero paid amounts
• View will be available to review this invoice if items are part paid or related to the Multiple Procedure Rule (MPR) and no edits can be made on this invoice 
• Allow Manual Payment, paid manually? add the manual payment and finalise the invoice
• Accept and Balance, write off the outstanding balance and move to finalised 
• Export this tab to excel 

Instructions 

1. Go to Claiming, Is this a Medicare, DVA or Health Fund/ECLIPSE claim?

If Medicare or DVA, select to Medicare

If Health Fund/ECLIPSE, select ECLIPSE

2. Go to the Exceptions tab 

3.  There are two status types that will display in Exceptions 

Exception status, means there will be error/s to action or part payment has been received

Rejected status, mean the entire claim has been rejected and there will be error/s to action

Medicare/ECLIPSE errors could display on each item or the invoice as a whole. drop down the invoice to show more details on each item number.
Tip Hover over the error for more information

4. Manage claims with the relevant actions based on the status. 

• Edit allows the option to edit invoices with unpaid items and remove items that have been rejected or not required on this claim.

• View will be available to open the invoice in read only. If items are part paid or related to the Multiple Procedure Rule (MPR) and no edits can be made. 

• Allow Manual Payment, paid manually? add the manual payment move the invoice to finalised 
• Accept and Balance, write off the outstanding balance and move to finalised 

5. Export this tab to excel