Claims built from care already recorded
Hospital accounts, Medicare and health fund claims, Support at Home claims and residential events come from the records your team already keeps. Nobody types them in twice.
Charges accrue on the episode from your own chargemaster and fund contracts, and Medicare, DVA and health fund claims are built from it.
Support at Home budgets, client contributions and claims through Aged Care Web Services, from one catalogue covering Support at Home, CHSP and DVA.
Entry, departure, leave and supplements lodged as events, with AN-ACC funding reconciled against Services Australia.
Plans imported, with budget against actuals and prices from the current price guide.
From the visit or the stay to the remittance
One catalogue for every funding stream
Each service maps to its Support at Home, CHSP or DVA funding line and price. Rates and categories are settings you change, not code we ship. Prices above the benchmark are flagged before they reach a client’s statement.
- Funding line and price matched automatically
- Only eligible services offered to each client
- Invoice line items with attachments
From the visit to the claim
When a worker finishes a visit, it becomes a delivery record. Budgets, client contributions and the claim are prepared from those records and lodged through Aged Care Web Services, then posted to your finance system for invoicing.
Claims reconcile themselves
Claims are matched automatically against payment statements and remittance advice, and anything that doesn’t match is put in front of you to review. Residential events and supplements such as oxygen and enteral feeding go through the same channel.
Accounts from your own prices
Private hospital billing runs on the hospital’s own chargemaster: accommodation, theatre bands tied to their MBS items, pharmacy and sundries, each at standard and contracted rates. Each health fund contract carries its per diem, case payment and DRG rates, and prosthesis charges come from the Prescribed List. The estimate a patient signs before admission is worked out from the same prices, and charges accrue on the episode as care is given.
- Chargemaster with standard and contracted rates
- Theatre bands and their billing rules
- Health fund contracts: per diem, case payment and DRG rates
Eligibility before billing
Medicare, DVA and private health fund claims go through Eclipse and Medicare Online, with eligibility checked before the bill is raised. A hospital episode with a finalised code set and DRG joins the claiming queue, claims go in batches you can follow, and remittances reconcile against the claims they pay. Submissions use PRODA, and we manage and rotate the device keys for you. Eclipse is in Notice of Integration testing with Services Australia.
NDIS plans, budget against actuals
Plans are imported with their budgets, and spend is tracked against them at current price guide rates. Claiming through PACE is in development.
See it in action
Elsewhere in the care circle
Bring us a month-end
We’ll walk a real claim from the visit or the stay to the remittance.