Access Anaesthetics FAQ

Can I send a claim for a private (not no-gap) patient?

Can I send a claim for a private (not no-gap) patient?

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Can I send a claim for a private (not no-gap) patient?

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Eclipse claims are usually no-gap claims sent directly to Medicare and the health fund. If the fund allows it, you may also send a separate copayment account to the patient. If the fund does not allow copayments to be charged when using its no-gap product, and you want to charge above the no-gap fee, then you must send a standard paper account to the patient. In this case, the patient will receive rebates up to the Medicare schedule fee only. That is, Medicare will pay 75% of the schedule fee, and the fund will pay 25%. The patient is then responsible to pay the difference between the schedule fee and the fee you have charged. In this case, you can't send an Eclipse claim. However you can send a patient claim.