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ECLIPSE Exception - All items fully unpaid

  • Updated

You may have an ECLIPSE claim that has been fully rejected by Medicare or the health fund and is showing as $0 paid. This can happen for numerous reasons such as:

  • There is a fundamental issue with the claim,
  • The claim was submitted more than once (duplicate),
  • A Medibank Private "No Gap" claim was submitted as an Agreement,
  • There is a problem with the provider registration with Medicare and / or the fund,
  • There is a problem with the patient registration with Medicare and / or the fund, or
  • The patient cannot be identified.

Highlight the claim in IMC Claims Control > Exceptions to Review and click the Review Exceptions button.

eclipse_exception_fullyunpaid.png

  1. Highlight each item in red and assess the messaging returned from Medicare and / or the health fund.
  2. You can then Close the Processing Report and delete the claim, then either resubmit the claim or delete the invoice entirely.
    1. Resubmit the claim:
      With the claim still highlighted, click Delete. Accept the prompt, then choose to Keep the invoice. Navigate to the patient's account history and make any changes to the invoice, then highlight all items on the invoice and click Resend IMC Exceptions to retransmit the claim.
    2. Delete the claim and the invoice:
      With the claim still highlighted, click Delete. Accept the prompt, then choose to Delete the invoice. You can then start the invoice from scratch if needed.