FAQ Automated Claiming

What can I do if I have accidentally billed the wrong item 

The option to remove this claim for automatic transmission is available on any invoice that has a ready status. Move to Draft will be available on the invoice on IN PROGRESS tab  

Why is the submit button no longer available?  

This means the patient is not verified or important information is missing on the invoice. Find this information on the invoice or IN PROGRESS tab 

The create claim button is no longer available, why? 

There is no need to create a batch. Bulk Bill, DVA, 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 is a fixed time. If claims are not ready for transmission leave them in draft status  

Where is the remittance ID?  

This ID is replaced by the payment ID found in the paid amount column once payment information is received for the claim.  

What is the date on the status column?  

This date is date it was submitted or failed in the IN PROGRESS tab, the date the invoice was rejected in the EXCEPTION tab, the date the claim was paid in the FINALISED tab 

Why is there no ACCEPTED tab for ECLIPSE anymore?  

This tab was related to the finalised claims, to streamline this workflow was have merged ACCEPTED and ERA into a single tab called FINALISEDThere will be two status types 

What does accepted mean?  

This 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 with relevant remittance information. 

What is the difference between failed claims IN PROGRESS and exception claims iEXCEPTIONS?  

Failed claims appear when a claim is not successfully transmitted to Medicare. Exception claims have received a response from Medicare with details to be actioned. 

What happened to my invoices in hidden?  

These invoices will be available IN PROGRESS with a draft status 

When can I send my assistant claims with the automated workflow? 

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

Can I edit claims found in the EXCEPTIONS tab?  

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

Can I move multiple draft invoices to ready status?  

Not for the first version., this will be coming as future improvements. 

Can I filter each of the tabs in claiming?  

We will be offering new and improved filters coming very soon!  

Why can I not see the delete option? 

Delete will only be available for an admin user on draft invoices. 

Will the invoice print when I enable print and then click either Submit or Draft 

Print will take place if you toggle on and choose any of the action's buttons including draft or submit. 

Can I create a Draft without a referral and edit/update in the ‘In Progress’ tab 

Yes, you will receive errors when selecting draft if information is missing and will not be able to submit until your resolve it 

What is the difference when you see the error icon next to ‘Draft’ and next to the ‘patient name’ in the ‘In Progress’ tab? 

Patient means verification has failed. Status means you are missing invoice information 

If I see the claim ID and the status ‘Submitted’ does that mean it worked? 

Yes, this was successfully transmitted to Medicare/ECLIPSE 

 What does it mean when I see the status ‘Submitted’ with an orange error icon? 

You have not submitted your claiming forms to Medicare (link can go here) 

In ‘Finalised’, when a claim has been accepted – where is this status? 

Accepted will show in the status column as Accepted  

How do we go about resubmitting the claim from the Exception section? As the Restore button has been removed, do we just make the amendments on the invoice and leave it there to be submitted at 1am? 

Edit replaces restore so that the changes can be made to the invoice where a new status Draft or Ready is chosen  

 I can see that Payment Report and ERA tabs are consolidated into one tab (Finalised) but it is not clear when does the claim comes into Finalised section. Is it when payment was approved or is it when the actual payment hits the back account? 

Finalised for Medicare will only show a single status, which is finalised. It will be when payment is received ad Medicare provides a payment response. Finalised for ECLIPSE will show an Accepted status for approved claims and Finalised for paid claims once 

Do we have customer facing help articles or videos surrounding this? 

A live webinar will be run on Friday the 13th of Dec where all users can register, this will be recorded and sent to all users. Questions asked during this webinar will be compiled and sent to all users and added to the knowledge base. 

 When are we providing more details to users? 

As well as the webinar. Knowledge base articles are going to be provided on release day as well as in app banners on the scheduler, invoices and claiming pages. 

 

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