This article provides basic instructions on how to create and send Patient Claims through ECLIPSE. The standard Genie invoicing method is not used when creating Inpatient Medical Claims (IMC).
If you do not have the ECLIPSE module and are interested in sending electronic inpatient medical claims, please follow this link to see if ECLIPSE is right for your practice.
Before you begin
In order for you to successfully send claims through ECLIPSE, you must first install HIC Online. Health Funds must also be correctly configured in Genie, and you must ensure your provider(s) are set up to claim. Please see our corresponding articles for further information on these prerequisites.
Please note: when it comes to assistant items, these can't be claimed on the same patient claim as the main surgical item numbers. To claim for assistants separately, please refer to our article on Assistant Invoicing.
Please note: Unlike other ECLIPSE claims, Patient Claims do not have their reports returned through Genie. The reason for this is that the benefit for these is payable to the patient, so once you have sent the claim, the processing and payment information is between the patient and Medicare/the fund; these claims will simply move into Finalised once processing is complete.
- With the patient highlighted in the Appointment Book or Patient List, navigate to Billing > IMC Invoice Wizard (Ctrl/Cmd + Shift + I). This window can also be accessed by right-clicking on the patient's name and selecting IMC Invoice Wizard;
- Select Claim Type as Patient Claim;
- Select other information as per the red text at the bottom of the window;
- Click Next to open the IMC Patient Claim Consent and Declaration form;
- Show patient the IMC Patient Claim Consent and Declaration form;
- Tick the Patient's Verbal Consent Received checkbox;
- Click Print or Close;
- Click Add Item to add a voucher;
- Select Provider, Referring Doctor, Informed Financial Consent etc. as appropriate;
- Click the Add Item icon;
- Enter the item number and press Tab on your keyboard;
- Enter the Charge Amount and Discount (if applicable) and any other item information;
- Click Save;
- Add any other items using the Add Item icon;
- Click Save to the voucher window;
- Click Next.
If claim is UNPAID:
- Click Next.
If claim is PAID:
- Tick the Fully Paid checkbox;
- Enter the full payment amount into the payment type fields and press the Tab key on your keyboard or Apply Deposit;
- Click Next.
- Select Now (Real-Time) or Later (Batch);
- Enter sender contact details if you wish;
- If unpaid, select the patient address that the provider cheque will be sent to. If paid, select which method of payment the patient would prefer for their refund;
- Click Transmit for Real-Time or Store for Batched;
- Select to either Print or Don't Print the invoice.