Eclipse Claiming (Gap) with Bluechip
Before you begin
*Claims not compliant with the Health Fund Contract
Eclipse Claims with a gap (out-of-pocket expense) is not compliant with a contracted amount with the Health Fund, and is a workaround.
It requires two accounts:
- An Eclipse account to claim to Medicare, and
- A Private account for the gap amount to the Patient.
Procedure
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From the Patient Details screen, select the Accounts menu item, and locate an existing Eclipse account.
- If an Eclipse account exists, right-click it and select . Proceed now to step 6, to issue the invoice to bill the Patient.
- If an Eclipse account does not exist, create a new Eclipse account. Continue now to Step 2.
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Click the New button. The window appears. Select the required Practitioner, Class as Eclipse and click OK.
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The
window appears.
- Select Health Fund Membership as New.
- For the field, either enter or click into the list to select the required fund.
- Enter the as on the health card. If the name differs, select the option above Health Fund.
- Enter the Membership No. , Ref No. and select the option. This will generate the details onto the Patient Details screen.
Note: If a Health Fund has been previously entered, it will automatically appear in the Health Fund drop down list.
- Click Verify Now to verity the Health Fund, clicking OK through the prompts, and then click OK to save the account.
- If a New, ensure that the required Practitioner is selected and the Class is Private. Click OK and OK again. does not exist, create a second account. Click
- Open the Eclipse account; right click and select .
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Issue an invoice for the Eclipse claim.
- Click the New Invoice button,
- Click OK or Continue to the verification prompt.
- Enter Item numbers required to populate total amounts.
- Tick Hospital. and select
- Click Issue, select Referral, and OK for date.
- Click the New Inpatient Medical Claiming window. button to display the
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Always; select Yes – Written when prompted 'Has the patient/Health Fund member been provided with informed financial consent', and then click Send to transmit the claim to Medicare.Note: If a Practice is setup as Agreement, there will be two options for Has the patient/Health Fund member been provided with informed financial consent. Yes – Written or Yes Verbal.
- Open the Private account, by selecting Accounts from the margin menu; double clicking on Private account or, highlight and click on the Open Existing Account button.
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Issue an invoice for the Patients gap.
- Click New Invoice.
- Enter Item number which will auto-populate an amount (if setup) or manually enter the amount.
- Click Add Receipt.
- Select Referral, and click OK to the date.
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The New Receipt window appears. Select a payment Type from the drop down menu, enter the amount, and allocate the invoice amount to the receipt amount by clicking the open box (right of amount). This will display a tick, click Issue, click OK to date; select receipt and File or Print.