Tyro Health Online’ ECLIPSE integration enables health professionals to process online eligibility checks and submit both in-patients medical and Overseas Visitors (in and out of hospital services) claims via Services Australia.
1. Sign up for Tyro Health Online
Log in to Tyro Health Online. If you have not yet signed up for your free Tyro Health Online Provider account, you can do so here.
Manual claims submissions for the nib and GU Health are no longer accepted, but you can use Tyro Health Online (previously "Medipass") to submit claims electronically via our ECLIPSE functionality - find out more.
2. Select ECLIPSE
Click on the "ECLIPSE" tile to begin. If you haven’t yet activated ECLIPSE, you can do so by following these instructions.
For in-patient claiming (e.g. MediGap), use our ECLIPSE integration not nib Direct - find out more about the different integrations.
3. Select claim option and type
Click on either the ‘In-patient medical claim’ or ‘Overseas claim’ tile then choose from the claim type drop-down. Find out more about which claim type to choose, including on whether to use an Agreement or Scheme.
DVA in-patient claims cannot be submitted via our ECLIPSE integration, however, this functionality is supported via our Medicare Online integration (processes both in-patient and out-patient services for DVA claims) - find out more.
4. Enter details or batch upload
Batch upload
Our ECLIPSE service includes batch upload functionality which can be selected after selecting a processing option - there are separate CSV templates for in-patient medical and overseas claims and they must be downloaded separately, refer to our step-by-step guide on batch uploads to see where you download these files and more.
To learn more about the batch upload information in the CSV template and which details are mandatory, check out the CSV file template guide and funder codes.
Enter details
For individual claim submissions, Tyro Health Online will request required information, including:
Invoice details: Enter an invoice number from your practice management software or accounting system and specify whether the account is paid in full or if it’s an accident or compensation claim.
Patient details: You can either search for a patient you have invoiced for before, or click 'Add New Patient' to enter their details. When you submit a claim for a new patient, their details will be saved to a Patient Record in Tyro Health Online, so they'll be remembered for next time.
Patient verification: Tyro Health Online verifies certain attributes with Services Australia when requested, such as on creation of a claim. A successful response indicates that the patient and/or claimant has an active account. If Medicare or private health insurer details are incorrect, you’ll receive an error on submission.
Principal provider & location details:
Enter the provider number of the health professional where the payment is to be directed. This is usually one of the servicing providers but can be any provider entered into Tyro Health Online and activated for Medicare Online and ECLIPSE functions. Providers will need to be set up for ECLIPSE in Tyro Health Online for them to appear here.
Enter the Facility ID, i.e. the hospital provider number where the admission took place - otherwise known as the Commonwealth Hospital Facility Provider Number. Find out how to manage these in Tyro Health Online here.
Medical events (each event):
Enter the provider number of the health professional providing services to a patient. For patient claims, the servicing provider must be the same across all medical events in a claim. Other claim processing classes support different servicing providers for each medical event.
Indicate that financial interest for treatment under a gap cover scheme has been disclosed to the insured patient.
Indicate how Informed Financial Consent was provided prior to treatment. If it was an emergency, “Not issued” or “Not obtained” must be used.
Enter referral details for services that normally require a referral - select “Yes” or set a referral override code when a referral isn’t available. Referrals are not applicable for General services claims (select “Omitted”).
Services (each event): Enter item codes for the service delivered and click ‘Show advanced options’ to enter additional service details. If needed, you can add multiple item codes by clicking ‘Add another item’. Depending on the item code, MBS fee may be populated, otherwise the amount will be blank.
The item code 'fee' you enter should be the scheduled benefit amount you can expect to be paid by Medicare and the private health fund, exclusive of any gap - find out more.
5. Submit invoice
Review the total amount of your invoice and click 'Submit Invoice'. If you want to process any out of pocket expenses (gap) via Tyro Health Online, after the summary page, click the ‘Get paid’ tab on the sidebar and then select the ‘Card payment’ option.
6. Summary page
After submitting your invoice, you’ll be taken to a summary screen, which contains all the information of your invoice and its current status. You can return to this screen any time to check the progress of an invoice by going to the 'Invoices' section of Tyro Health Online.
If you have any questions, click on the pink chat bubble on our website or email our Customer Support team. Tyro Health also offers an extensive User Guide for ECLIPSE - you can also request this from our support team.