Eclipse is a Medicare initiative that enables doctors, health funds, Medicare Australia and practice administrators to lodge and settle claims electronically and securely.
All participating AHSA funds use Eclipse. AHSA also encourages medical providers to use Eclipse. It provides a secure method for the submission of claims for in-patient medical services and processes these automatically through both Medicare and the fund, creating a more efficient payment cycle.
For detailed information about Eclipse, contact your software vendor or the Medicare Australia eBusiness Service Centre on 1800 700 199. You can also visit the Services Australia website.
Tips on using Eclipse
'Fund ID'
The Fund IDs are located in your practice's software packages. Your software program will download the latest list of Fund IDs. Your practice should contact your software vendor if you are unable to locate the 'Fund ID' button in your software package.
Funds' Eclipse Participant ID is also available in the Access Gap Cover Participating Funds Contact List. You can contact the Medicare Australia eBusiness Service Centre on 1800 700 199 or email co.eclipse@medicareaustralia.gov.au.
Doctors 'Payee ID'
The Doctor's Payee ID is the Provider Number attached to the specific practice location.
Is Access Gap Cover a Scheme or Agreement for Eclipse claims?
Schemes
If you are using Eclipse to submit your Access Gap Cover claims, please use 'Scheme' for all AHSA Funds except HBF. For HBF, please use ‘Agreement’.
There are two types of Gap Cover Schemes:
- No Gap Cover - is where the patient does not have any out-of-pocket expenses.
- Known Gap Cover - is where the patient does have out-of-pocket expenses and the doctor or practice staff must provide written informed financial consent.
Agreements
If your organisation has signed an MPPA or a HPPA/PA with AHSA, please use 'Agreement'. There are two types of agreements:
- Hospital Purchaser Provider Agreement/Practitioner Agreement (HPPA/PA) is the combination of agreements between the practitioner and the hospital, and between the hospital and a private health fund.
- Medical Purchaser Provider Agreement (MPPA) is an agreement between the practitioner or company and the private health fund.