Overview
An In Hospital Claim (IHC) Invoice is for hospital services sent to the health fund.
There are some mandatory configurations required in CareRight for the successful processing of In Hospital Claims. Refer to the Configurations For IHC claims in the System Admin Guide.
CareRight is able to process In Hospital Claims in three ways:
- Via ECLIPSE (direct from CareRight - for both same day and longer stay admissions)
- Via Thelma (ehealthwise - for overnight or longer stay admissions).
Note: As of September 2023, this approach is no longer in use for new customers. - Paper-based HC21 - where a health fund does not work with Eclipse, or in instances where the patient is deceased.
1. ECLIPSE (direct via CareRight)
Invoices eligible for In Hospital claims will be notified to the user in the Claim information field.
Refer to IHC - Generate an Eclipse claim for instructions on how to generate an Eclipse IHC.
2. Thelma (eHealthwise) - long stay (overnight admissions)
CareRight is integrated with Thelma for multiday claiming.
Refer to IHC - Generate a Thelma file for instructions on how to generate a Thelma file for IHC claim.
3. Paper-based HC21
For those health funds which are not configured or enabled for online claiming either via Eclipse or Thema, CareRight will generate the HC21 Forms.
Refer to IHC -Generate an HC21 for instructions on how to generate a paper-based claim.
