Sometimes, despite your best efforts, ECLIPSE claims can be sent with the wrong information. It's tempting to just delete them and start again, but these claims are like emails or SMS messages - Medicare receives them as soon as they're sent.
Deleting the claims from Genie won't remove them from Medicare's servers, so you may end up being paid for a claim you've erroneously deleted in Genie.
This guide explains what you need to do to cancel the claim before fixing it and sending it off again.
If you realise you've submitted a claim incorrectly, firstly check the claim's status to determine who to contact.
- Navigate to File > Maintenance & Reports > Daily;
- Select the ECLIPSE IMC Transmission option to open the IMC Claims Control window;
- Highlight the claim within the list, then click Get Report Status.
Once you click Get Report Status, you will be able to tell who to contact to cancel the claim based on the Process Status.
|MEDICARE_ASSESSING||Call Medicare to cancel the claim|
|HEALTH_FUND_ASSESSING||Call the fund to cancel the claim. Medicare has already forwarded the claim to them.|
Depending on the advice from Medicare or the fund, you will need to either delete the claim now, or wait until the claim is rejected.
Alternatively, if they were able to edit the claim details on their end, you may be advised to just edit the invoice in Genie without resubmitting.
As the claims are sent through an automated system, sometimes Medicare / the fund cannot make adjustments on their end. You should always be guided by the advice from Medicare or the fund in each case on how to make the correct adjustment.
If Medicare or the fund advise you to delete the claim, you can do this through the IMC Claims Control window by right-clicking on the claim and choosing the option.
If Genie asks for a password, please call Support on 1300 889 362 to obtain this.
When you receive the prompt ‘Are you sure you want to delete this claim?', choose Delete.
Genie will then ask if you would like to Keep or Delete the associated invoice:
If you need to slightly adjust the invoice but are planning on resending the claim through ECLIPSE, then you can Keep the invoice.
If you have charged the wrong item number/s it may be easier to Delete the invoice as well and start over.
You can find any of your deleted claims within the Deleted section of the IMC Claims Control window.
Important note for known gap claims
If you are trying to delete a Known Gap invoice along with the claim but have already applied the patient's payment, you will need to delete the payment from their account history first before deleting the invoice.
If the banking containing this payment has been sealed, you will need to use your dummy bank account when re-receipting the payment. If you are unsure how to do this, please contact support.
If you kept the invoice in Step 3, navigate to the patient's account history from the appointment book or patient list (Billing > Account History) and make the appropriate changes so it reflects the correct information. You can then resubmit it as follows:
- In the Account History window, highlight the invoice on the left;
- On the right, highlight the items you would like to resubmit by Ctrl/Cmd + clicking on each item;
- Click ‘Resend IMC Exceptions’;
- In the window that opens, check the details look correct; and
- Click ‘Transmit’ to re-transmit the claim.
Alternatively, if you chose to delete the invoice when you deleted the claim, you can recreate it from scratch through Billing > IMC Invoice Wizard.