Depending on how you charge for your in-patient services, including whether you're enrolled in any No Gap or Known Gap programs, the fee amount you set for an item in Tyro Health Online (ECLIPSE) may differ.

After selecting an item code in Tyro Health Online (for ECLIPSE) the fee amount that will be automatically populated is the MBS fee amount. If you are enrolled with a private health fund Agreement or Schedule program, the fee should align to that specified by the program and may differ from the MBS fee amount.

For No Gap programs, the fee amount you enter should be the scheduled benefit amount as advised by the Funds. This is the total amount you can expect to be paid by Medicare and the private health fund.

For example, an item code has an MBS fee of $46.15 and your No Gap program entitles you to a schedule amount of $74.40, so in order to receive the full $74.40 you need to input $74.40 as the fee.

For Known Gap claims, how you process the Out Of Pocket may differ across Health Fund's, please confirm with the patients Health Fund on the appropriate way to apply any out of pocket gaps for a claim.

To find out more about submitting claims for No Gap and Known Gap programs, please check out this help article.

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.