ECLIPSE Claims #

ECLIPSE In-patient medical claims (IMC) require both Medicare and Fund details on the claim. The structure is otherwise the same as other API claim types. Specialist claims (serviceType = “S”) will require a referral.

Commonly used IMC types are:

Agreement type claims (AG) where the provider has an agreement with the Fund (eg BUPA)
Schemes (SC) for general No Gap or Known Gap claims
Patient claims (PC) used where the patient has paid the claim in full

The API can also support claims for Billing Agents, contact us if you require more information on this.

NOTE: Claims with a date of service more than two years ago can’t be accepted electronically and must be lodged manually with Medicare or the private health insurer.

`POST` - Submit an ECLIPSE claim (Scheme) #

IMC Scheme claims are the most commonly used.

Set imcClaimType to “SC” and accountPaid set to “N”

{{base_url}}/{{version}}/claims?location={{location_id}}

Headers

Header	Value
Accept	application/json
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_invoiceNumber": 99226,
    "type": "BulkBill",
    "flags": {
        "accountPaid": false,
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": 36.55,
            "date": "2022-03-24",
            "itemNumber": "105",
            "selfDeemedCode": "SS"
        }
    ],
    "location": {
        "type": "R"
    },
    "patient": {
        "dateOfBirth": "1962-06-23",
        "fund": {
            "eclipseId": "STS",
            "number": "12345678",
            "ref": "2",
            "payeeId": "343434"
        },
        "gender": "F",
        "medicare": {
            "number": "2950552261",
            "ref": "2"
        },
        "name": {
            "family": "BAILEY",
            "first": "CANDY"
        }
    },
    "provider": {
        "servicing": "2418291F"
    },
    "referral": {
        "date": "2022-03-24",
        "periodType": "S",
        "provider": {
            "number": "2121331W",
            "type": "S"
        },
        "referralType": "S"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "SC",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "144.40",
            "date": "{{today}}",
            "itemNumber": "30026"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1962-06-23",
        "fund": {
            "eclipseId": "STS",
            "number": "12345678",
            "ref": "2"
        },
        "gender": "F",
        "medicare": {
            "number": "2950552261",
            "ref": "2"
        },
        "name": {
            "family": "BAILEY",
            "first": "CANDY"
        }
    },
    "provider": {
        "principal": "2408271B",
        "servicing": "2408271B"
    },
    "referral": {
        "date": "{{yesterday}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 180067,
  "medicareClaimId": "180067",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000pI8fdhhCTFeueJFL"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	149
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS

`POST` - Submit an ECLIPSE claim (Agreement) #

IMC Agreement claims are used for some funds such as BUPA.

Set imcClaimType to “AG” and accountPaid set to “N”

NOTE: BUPA also requires a Payee ID on all IMC claims, set this in patient.fund.payeeId

{{base_url}}/{{version}}/claims?location={{location_id}}

Headers

Header	Value
Accept	application/json
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "144.40",
            "date": "{{today}}",
            "itemNumber": "30026"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1962-06-23",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678",
            "ref": "2",
            "payeeId": "343434"
        },
        "gender": "F",
        "medicare": {
            "number": "2950552261",
            "ref": "2"
        },
        "name": {
            "family": "BAILEY",
            "first": "CANDY"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{yesterday}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "SC",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "144.40",
            "date": "{{today}}",
            "itemNumber": "30026"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1962-06-23",
        "fund": {
            "eclipseId": "STS",
            "number": "12345678",
            "ref": "2"
        },
        "gender": "F",
        "medicare": {
            "number": "2950552261",
            "ref": "2"
        },
        "name": {
            "family": "BAILEY",
            "first": "CANDY"
        }
    },
    "provider": {
        "principal": "2408271B",
        "servicing": "2408271B"
    },
    "referral": {
        "date": "{{yesterday}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 180068,
  "medicareClaimId": "180068",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000E7EbGriJh5xUtQJb"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	149
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS

`POST` - Submit an ECLIPSE claim (Patient Claim) #

IMC Patient claims are used when the patient has paid in full and you want to submit the claim to the fund on their behalf.

Set imcClaimType to “PC” and accountPaid set to “Y”. You can optionally set claimant details if they are different to the patient.

NOTE: There will be no payment reports for IMC-PC claims, the payment goes directly to the patient, typically 75% of the MBS fee from Medicare and 25% of the MBS fee from the fund.

{{base_url}}/{{version}}/claims?location={{location_id}}

Headers

Header	Value
Accept	application/json
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "Y",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "PC",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "144.40",
            "date": "{{today}}",
            "itemNumber": "30026"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1962-06-23",
        "fund": {
            "eclipseId": "STS",
            "number": "12345678",
            "ref": "2"
        },
        "gender": "F",
        "medicare": {
            "number": "2950552261",
            "ref": "2"
        },
        "name": {
            "family": "BAILEY",
            "first": "CANDY"
        }
    },
    "claimant": {
        "dateOfBirth": "1951-04-24",
        "medicare": {
            "number": "5950969521",
            "ref": 1
        },
        "gender": "F",
        "name": {
            "first": "Jamee",
            "family": "Post"
        },
        "phone": "0414141414"
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{yesterday}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "Y",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "PC",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "144.40",
            "date": "{{today}}",
            "itemNumber": "30026"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1962-06-23",
        "fund": {
            "eclipseId": "STS",
            "number": "12345678",
            "ref": "2"
        },
        "gender": "F",
        "medicare": {
            "number": "2950552261",
            "ref": "2"
        },
        "name": {
            "family": "BAILEY",
            "first": "CANDY"
        }
    },
    "claimant": {
        "dateOfBirth": "1951-04-24",
        "medicare": {
            "number": "5950969521",
            "ref": 1
        },
        "gender": "F",
        "name": {
            "first": "Jamee",
            "family": "Post"
        },
        "phone": "0414141414"
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{yesterday}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 184335,
  "medicareClaimId": "184335",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP000009u1rc0aeO7Lq3ANG"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	149
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS

`POST` - Submit an IMC Specialist claim with standard referral and DI item #

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_TestCase": "Submit an IMC Specialist claim with standard referral and DI item",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "67.20",
            "date": "{{today}}",
            "itemNumber": "104"
        },
        {
            "chargeAmount": "37.65",
            "date": "{{today}}",
            "itemNumber": "57524",
            "lspNumber": "000014"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "_TestCase": "Submit an IMC Specialist claim with standard referral and DI item",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "67.20",
            "date": "{{today}}",
            "itemNumber": "104"
        },
        {
            "chargeAmount": "37.65",
            "date": "{{today}}",
            "itemNumber": "57524",
            "lspNumber": "000014"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 187467,
  "medicareClaimId": "187467",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000LMQd2lDCbHjjYmBc"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	183
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS
Strict-Transport-Security	max-age=3153600; includeSubDomains; preload
X-XSS-Protection	1; mode=block
X-Content-Type-Options	nosniff
X-Frame-Options	SAMEORIGIN

`POST` - Submit a specialist consultation service with a simple pathology service #

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_TestCase": "Submit a specialist consultation service and a simple pathology service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "67.20",
            "date": "{{today}}",
            "itemNumber": "104"
        },
        {
            "chargeAmount": "5.20",
            "date": "{{today}}",
            "itemNumber": "73801"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "_TestCase": "Submit a specialist consultation service and a simple pathology service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "67.20",
            "date": "{{today}}",
            "itemNumber": "104"
        },
        {
            "chargeAmount": "5.20",
            "date": "{{today}}",
            "itemNumber": "73801"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 187468,
  "medicareClaimId": "187468",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000wScw9cmJIzZaKQQM"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	149
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS
Strict-Transport-Security	max-age=3153600; includeSubDomains; preload
X-XSS-Protection	1; mode=block
X-Content-Type-Options	nosniff
X-Frame-Options	SAMEORIGIN

`POST` - Submit a specialist consultation with a requested Diagnostic Imaging service #

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_TestCase": "Submit a specialist consultation with a requested Diagnostic Imaging service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "67.20",
            "date": "{{today}}",
            "itemNumber": "104"
        },
        {
            "chargeAmount": "129.05",
            "date": "{{today}}",
            "itemNumber": "55252",
            "lspNumber": "000014"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "_TestCase": "Submit a specialist consultation with a requested Diagnostic Imaging service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "67.20",
            "date": "{{today}}",
            "itemNumber": "104"
        },
        {
            "chargeAmount": "129.05",
            "date": "{{today}}",
            "itemNumber": "55252",
            "lspNumber": "000014"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "periodType": "S",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 187469,
  "medicareClaimId": "187469",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000XPfrxA1f24wtdrQP"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	149
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS
Strict-Transport-Security	max-age=3153600; includeSubDomains; preload
X-XSS-Protection	1; mode=block
X-Content-Type-Options	nosniff
X-Frame-Options	SAMEORIGIN

`POST` - Submit a non requested diagnostic imaging service #

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_TestCase": "Submit a non requested diagnostic imaging service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "28.80",
            "date": "{{today}}",
            "itemNumber": "55029",
            "lspNumber" :"000014"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "overrideCode": "N"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "_TestCase": "Submit a non requested diagnostic imaging service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "28.80",
            "date": "{{today}}",
            "itemNumber": "55029",
            "lspNumber" :"000014"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "overrideCode": "N"
    }
}'

Example Response:

Body:

{
  "claimId": 187470,
  "medicareClaimId": "187470",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000CYY0ddW2Oz66zzTh"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	183
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS
Strict-Transport-Security	max-age=3153600; includeSubDomains; preload
X-XSS-Protection	1; mode=block
X-Content-Type-Options	nosniff
X-Frame-Options	SAMEORIGIN

`POST` - Submit a requested diagnostic imaging service #

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_TestCase": "Submit a requested diagnostic imaging service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "28.80",
            "date": "{{today}}",
            "itemNumber": "55028",
            "lspNumber": "000014"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "provider": "2054781W",
        "referralType": "D"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "_TestCase": "Submit a requested diagnostic imaging service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "28.80",
            "date": "{{today}}",
            "itemNumber": "55028",
            "lspNumber": "000014"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "provider": "2054781W",
        "referralType": "D"
    }
}'

Example Response:

Body:

{
  "claimId": 187471,
  "medicareClaimId": "187471",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000qZGoYaUhBZxUaY63"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	183
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS
Strict-Transport-Security	max-age=3153600; includeSubDomains; preload
X-XSS-Protection	1; mode=block
X-Content-Type-Options	nosniff
X-Frame-Options	SAMEORIGIN

`POST` - Submit a requested Pathology service with a Self Deemed Pathology service #

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "_TestCase": "Submit a requested Pathology service with a Self Deemed Pathology service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "P"
    },
    "items": [
        {
            "chargeAmount": "5.90",
            "date": "{{today}}",
            "itemNumber": "65060",
            "scpId": "00001"
        },
        {
            "chargeAmount": "7.80",
            "date": "{{today}}",
            "itemNumber": "65066",
            "scpId": "00001",
            "selfDeemedCode": "SD"
        }
    ],
    "location": {
        "name": "St Elsewhere's Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "provider": "2054781W"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "_TestCase": "Submit a requested Pathology service with a Self Deemed Pathology service",
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "financialInterestDisclosureInd": "Y",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "P"
    },
    "items": [
        {
            "chargeAmount": "5.90",
            "date": "{{today}}",
            "itemNumber": "65060",
            "scpId": "00001"
        },
        {
            "chargeAmount": "7.80",
            "date": "{{today}}",
            "itemNumber": "65066",
            "scpId": "00001",
            "selfDeemedCode": "SD"
        }
    ],
    "location": {
        "name": "St Elsewhere'\''s Hospital",
        "provider": "9988770W",
        "type": "H"
    },
    "patient": {
        "dateOfBirth": "1951-04-24",
        "fund": {
            "eclipseId": "TST",
            "number": "12345678"
        },
        "gender": "F",
        "medicare": {
            "number": "5950969521",
            "ref": "1"
        },
        "name": {
            "family": "POST",
            "first": "Jamee"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "provider": "2054781W"
    }
}'

Example Response:

Body:

{
  "claimId": 187472,
  "medicareClaimId": "187472",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000PCkV5Au2gltLqA8T"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	183
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS
Strict-Transport-Security	max-age=3153600; includeSubDomains; preload
X-XSS-Protection	1; mode=block
X-Content-Type-Options	nosniff
X-Frame-Options	SAMEORIGIN

ECLIPSE Claims #

POST - Submit an ECLIPSE claim (Scheme) #

POST - Submit an ECLIPSE claim (Agreement) #

POST - Submit an ECLIPSE claim (Patient Claim) #

POST - Submit an IMC Specialist claim with standard referral and DI item #

POST - Submit a specialist consultation service with a simple pathology service #

POST - Submit a specialist consultation with a requested Diagnostic Imaging service #

POST - Submit a non requested diagnostic imaging service #

POST - Submit a requested diagnostic imaging service #

POST - Submit a requested Pathology service with a Self Deemed Pathology service #

`POST` - Submit an ECLIPSE claim (Scheme) #

`POST` - Submit an ECLIPSE claim (Agreement) #

`POST` - Submit an ECLIPSE claim (Patient Claim) #

`POST` - Submit an IMC Specialist claim with standard referral and DI item #

`POST` - Submit a specialist consultation service with a simple pathology service #

`POST` - Submit a specialist consultation with a requested Diagnostic Imaging service #

`POST` - Submit a non requested diagnostic imaging service #

`POST` - Submit a requested diagnostic imaging service #

`POST` - Submit a requested Pathology service with a Self Deemed Pathology service #