Eclipse Claiming (No Gap) with Bluechip

Before you begin

Eclipse Claims are direct communication for providers with Medicare and the Health Fund in one transaction. Eclipse Claims (no gap) amounts are as contracted with the Health Fund and the Practitioner. This handout will assist with explaining the process and the resulting report for tracking your claim

Eclipse Claims with no gap require a single account; the Eclipse account for claiming with Medicare.

Procedure

To complete a claim:
  1. 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 Open Account. 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.
  2. Click the New button. The = > New Account window appears. Select the required Practitioner, Class as Eclipse and click OK.
  3. The Account Details window appears.
    • Select Health Fund Membership as New.
    • For the Health Fund field, either enter or click into the list to select the required fund.
      Tip:
      If a Health Fund has been previously entered, it will automatically appear in the Health Fund list.
    • Enter the Account Name as on the health card. If the name differs, select the option above Health Fund.
    • Enter the Membership No., Ref No. and select the Default Membership option. This will generate the details onto the Patient Details screen.
  4. Click Verify Now to verity the Health Fund, clicking OK through the prompts, and then click OK to save the account.
  5. Open the Eclipse Account; right click and select Open > Account.
  6. 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 > Services and select Hospital
    • Click Issue, select Referral, and OK for date
  7. Click the IMC Submission button to display the New Inpatient Medical Claiming window.
    Always select Yes - Written when prompted 'Has the patient/Health Fund member been provided with informed financial content', 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.
  8. 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.
  9. 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.


  10. 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.

What to do next

Access the Eclipse report, Inpatient Medical Claim Report