IHC (In Hospital Claim)

Explanation of the concept of In Hospital Claims in the CareRight system.

In Hospital Claiming (Eclipse) - Day Hospital Note : Please confirm the mandatory configurations are done correctly in CareRight for the successful handling of IHC Claim via Eclipse. Refer to Configurations for the IHC Claim in the sy...

Generate a Thelma file If the health fund is configured for Manual Claiming or Electronic Claiming (Thelma), CareRight will create an XML file and this can be uploaded into Thelma (ehealthwise) manually. From the invoice eligible for IHC Clai...

Generate an HC21 Form HC21 claiming is a manual process to claim In-Hospital claims via the HC 21 Form. For some Health funds, this may be the only option while, for others, it may be an interim process whilst eclipse claim onboarding is occur...

Explanation of the concept of a Held Claim in the CareRight system, how to mark a held claim and how to claim once after all admissions are recorded.

Express IHC Claiming Express IHC Claiming enables the user to skip the majority of the IHC claiming screens if the conditions are met that the information can be reasonably assumed.  Express claiming will attempt to create and validate an IHC cl...

What is a Type C certificate? From  https://www.health.gov.au/topics/private-health-insurance/private-health-insurance-reforms/type-c-hospital-certification Types of hospital procedures The  Private Health Insurance (Benefits Requiremen...

Theatre Banding for IHC Claiming When claiming multiple procedures via IHC you have to ensure that each procedure is correctly classified to the required theatre band (number). Theatre Band to use is generally standardized across all funds, but ...

Introduction This article applies to IHC claiming both same day and multi-day stay claiming. When moving from claiming using HC21 forms to sending claims using ecplise there a few minor differences that will need to be considered. Setup The fi...

Claim adjustments (Resubmit IHC) After successful submission of the claim it may be necessary to send an adjustment to the claims. For example, this may be an alteration to the charges of the claim. This can be performed from the claim tab. A...

In some cases, the Accommodation Status Code may not reflect the actual circumstances of your treatment of a patient. In these scenarios, you can visit IHC Invoice > Claim (non-express) > Create New Claim (if required) > Next You will be presented...

Hospital claims for deceased patients may need manual submission as all the Medicare channels will be frozen by the time the patient's death status has been confirmed in the systems. These IHC Claims can be submitted through manual HC21 forms.  St...