Automated Claiming FAQs

INVOICING:

Can I save an invoice as Draft without a Referral?

Yes.  You can save an invoice with known missing information/verification errors and resolve at a later time.  The Draft invoice can be found in the In Progress tab or the Invoice History of the patient.  

What should I do if I have billed an incorrect item 

All invoices that are in the Ready status will be transmitted each day at 1.00am AEST.  You can amend the invoice any time before it is sent.  If you need to, you can prevent an invoice from being transmitted by changing the status from Ready to Draft in the In Progress tab using the Action column.  

How do I print the Invoice, Bulk Bill or DVA form?

Before finishing the invoice, use the toggle switches at the bottom to select the item/s to print.  When you click Submit or Draft, your selections will print.

Why is the Submit button showing as greyed out?  

This indicates that there is missing information and the invoice is not able to be transmitted.  You can still save the invoice as Draft and resolve at a later time if required.  

Why am I unable to see the Delete option? 

The Delete function is only available for an Admin user on invoices in Draft status. 

What happened to my invoices in hidden?  

These invoices will be available in the In Progress tab with a Draft status 

 

SUBMITTING CLAIMS:

Why is the Create Claim button no longer available? 

With automated claiming, there is no need to create a batch.  Bulk Bill, DVA, and ECLIPSE claims with a Ready status will be transmitted automatically at 1:00AM AEST.  

Can I change the time that the claims are transmitted?  

No, this time was chosen to be the least disruptive to your practice.  If an invoice is not ready for transmission, leave it in Draft status.

When can I send my Assistant Claims with the automated claiming workflow? 

The claims can be sent after the main surgeon has sent their claim 

Can I move multiple Draft invoices to the Ready status?  

Yes.  In the In Progress tab, use the Submit All Draft button to update all Draft invoices to Ready status.  Click here to learn more for Medicare claims or ECLIPSE claims.  

Why is the Submit All Draft button missing?

If there are no Draft invoices in the current list, the button will not display.  Adjust your filters or scroll to the next page of results to find your Draft invoices.

 

MANAGING CLAIMS:

Can I filter each of the tabs in Claiming?  

Yes, filtering is available in the Claiming section:

  • Within Medicare Claiming you can filter by Patient Name, Location, Invoice Type, Date Created/Submitted/Finalised, and Payment ID depending on which tab you are in. 
  • Within ECLIPSE Claiming you can filter by Patient Name, Location, Health Fund, Date Created/Submitted/Finalised and Payment ID depending on which tab you are in.  

Where is the Remittance ID?  

The Remittance ID is replaced by Payment ID, which can be found in the Paid Amount column once the Payment Report has been received for the claim.  

How do I know that my claim has been successfully sent?

Claims that have been transmitted successfully will have a Claim ID and be in Submitted status. 

What is the Date on the Status column for?  

The meaning of the date changes depending on the tab that you are viewing:

  • In Progress tab Date shows when the claim was submitted/failed. 
  • Exception tab Date shows when the claim was rejected. 
  • Finalised tab Date shows when the claim was paid.  

What is the difference between a Failed claim and an Exception claim?

The In Progress tab shows Failed claims, which are claims that have not been successfully transmitted to Medicare and require resolving.  The Exception tab shows Exception claims, which are claims that have returned from Medicare/Health Fund that require actioning.  

Can I edit claims found in the Exceptions tab?  

Items with a zero paid amount can be deleted, re-added and resent for payment.  If items are related to the MPR they will show with an orange bar and cannot be edited. 

How do I resubmit a claim from the Exception tab?

Use the Edit button in the Action column to open the invoice and make necessary adjustments.  From there you can select Draft or Submit.  Click here for more information about Exception and Rejection handling.  

How do I know what the Error icon is referring to?

Hovering your cursor over the Error icon will advise you where the issue is that needs resolving.  

What does the orange error mean next to the Submitted status?

Claims with an orange error icon indicate that the required forms have not been sent/processed with Medicare to allow claim transmission to proceed.  Please contact Medicare.

 

ECLIPSE SPECIFIC FAQ:

Why is there no Accepted tab for ECLIPSE anymore?  

The Accepted tab showed claims that were accepted but not yet paid and the ERA tab showed claims that were paid.  As part of the automated claiming changes, we have streamlined these two claim statuses into one new tab called Finalised.  To learn more, click here.

What does the Accepted status mean?  

The Accepted status will show when the claim has been approved for payment by the Health Fund.  Once the payment is received the invoice will update to Finalised status and you will be able to review the remittance details.  

How do I know when an ECLIPSE claim has been accepted?

The Finalised tab will show you the status of the claim.  Accepted means that it has been approved but not yet paid, Finalised means that it has been approved and paid.  

Was this article helpful?
0 out of 0 found this helpful
Have more questions? Submit a request