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E- Claims Management

MIMSYS claim module sends bills to insurance sites for approval. With this module you can create claims based on visit (All bill for a visit combined and send as a single claim)/Bill. Separate claims for OP internal Bills, OP external Bills, OP Bills, Pharmacy bills, IP Bills, Pharmacy internal and Pharmacy external can be created and reports to a claim (Lab, Radiology, Histopathology, Microbiology, Cytology, Patient summary, Insurance card) can be attached. The Re-claim screen will allow sending rejected claims again for approval.

Electronic Claim Lodgment and Information Processing Service Environment (ECLIPSE) is an extension of Medicare Online claiming. It offers a secure connection between:

  • Health professionals
  • Public and private hospitals
  • Billing agents
  • Private health insurers
  • The Department of Veterans’ Affairs
  • Medicare

It includes direct communication in the one transaction between health professionals, MIMSYS and private health insurers.

ECLIPSE can be used for both paid and unpaid inpatient medical claims and can be lodged directly through MIMSYS. ECLIPSE can also be used to lodge in hospital claims from public and private hospitals and day facilities in relation to the patient’s hospital stay. This includes claims for accommodation, transfers, and miscellaneous items like prosthetics and the following claim types:

  • Online Patient Verification (OPV)
  • Online Veteran Verification (OVV)
  • Online Eligibility Check (OEC)
  • Status Request (STS)
  • OEC Reporting
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