Simplified Billing and ECLIPSE forms
There are several forms that relate to Simplified Billing and ECLIPSE
Use the Simplified Billing or ECLIPSE adjustment form to request a latter day adjustment to a Simplified Billing or ECLIPSE claim.
Use the Hospital or Day Procedure Centre Registration for In Hospital Claiming form to register a hospital a day procedure centre for In Hospital claiming.
Use the Application for late lodgement of a Simplified Billing claim for assigned Medicare benefits form to apply for the lodgement of a Simplified Billing claim for assigned Medicare benefits, which must be submitted to us through a nominated private health insurer or Billing Agent.
Private Health Insurers (PHIs) use the Private health insurer registrations and updates for ECLIPSE form to either:
- register and update PHI details for ECLIPSE, Electronic Data Interchange (EDI) and manual claiming
- add or remove ECLIPSE functionality.
Private health insurers or approved billing agents can use the Simplified Billing Manual Claims batch header form to submit manual simplified billing claims.
Page last updated: 24 October 2019
This information was printed 6 July 2020 from https://www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/simplified-billing-and-eclipse/resources/simplified-billing-and-eclipse-forms. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.