Can you make claims to all kinds of funds?

Yes! We submit claims to Medicare, Veterans Affairs, Workers Comp, and other health funds. Please note:

• We can submit bulk billed/Veterans claims (in- or outpatient claims) where the date of service is no more than 2 years old.
• We can submit health funds claims (inpatient claims only) where the date of services is no more than 2 years old and your provider number was registered with the health fund before the date of service.

Does the money from health fund claims go to you?

No, the money from Medicare, Veteran’s Affairs, and all other health funds gets deposited directly into your nominated bank account. We will send you an invoice at the end of each month for our services.

Can I send you a backlog of claims?

Of course, please do! We love helping you get caught up. We can submit claims as long as they’re no more than two years old. For health fund claims (inpatient claims only) your provider number has to have been registered with the health fund before the date of service.

What information do I need to send?

We will need the following about the patient:

• First name and last name
• Date of birth
• Gender
• Medicare number (or veterans number)
• Health fund and membership (if billing the health fund)
• Referring doctor and referral date (if required)

We will also need the date of service and the item number/s you wish to bill. If you work at a hospital, we recommend grabbing a sticker from the hospital, as this will have all the patient details already and then on a sheet of paper, add the missing information. Handwritten is fine.

How do I send you my claim information so that you can bill it for me?

Using whatever method works for you. If you have a backlog of claims sitting in a box, you can send it by post or hand-deliver it to us. You can also upload data to our secure portal, fax it to us, or we’ll soon have a mobile app (Apple and Android) where you can enter the details and send it securely to us.

How and when do you get paid?

Since all money from claims and invoices goes directly into your bank account, we will send you an invoice at the beginning of the following month, with a summary of the claims that have been paid. We calculate our fee based on a percentage of claims paid, not bills sent — meaning we only get paid if you do.

When will I get paid?

Payment timelines from health funds vary, but here are the averages:

• Medicare online–claims are paid within 2-4 business days, except pathology claims.
• ECLIPSE–health funds in-hospital claims will be paid within 3-4 weeks, with most funds paying within 2-4 business days.