Online Claiming
How to collect Assignment of Benefits
Introduction CESoft has functionality to assist you in collecting Assignment of Benefits (AoB) from patients when required. For a full discussion of the legislative changes see ...
Statement of Claim and Benefit form
A Statement of Claim and Benefit is provided to the claimant when a patient claim has been lodged in real time, processed by the agency and a benefit amount returned to the claimant. In CE, this form is generates when the user submits a PCI ...
New Assignment of Benefit Requirements from 1/7/2026
UPDATE: This article has been updated with revised information based on the June 18th announcement from The Department of Health, Disability and Ageing. Please check back from time-to-time for further updates. Background Under the Health Insurance ...
Bulk Bill Post-Assignment of Benefit Form (DB4)
A Bulk Bill Assignment of Benefit Form (DB4) is provided when a bulk bill claim has been submitted to the agency for processing, for the benefit amount to go to the health professional. When submitting a Bulk-Bill claim to Medicare, CESoft will ...
Lodgement Advice Form
A Lodgement Advice is provided to the claimant when a patient claim has been lodged in real time and referred to an agency operator for action. In CE, this means that a PCI (Medicare) claim has been submitted with an acceptible error, which results ...
Submitting fully paid accounts
With Cutting Edge you can submit fully paid Medicare Claims and Inpatient Claims, with the rebate going directly to the patient. Effectively you are submitting a fully paid claim on behalf of the patient, saving them the need to submit it themselves. ...
Order for Anaesthetic Items
The correct order for anaesthetic claims is as follows: Pre-op consultation item (17610 to 17690) Anaesthetic base item (20100-21997 or 22900–22905 if you're the anaesthetist, 25200 or 25205 if you’re the assistant anaesthetist, 22060 if you’re the ...
Online Eligibility Check (OEC) and Cover Check
Cutting Edge Software has two functions for pre-checking a patient's eligibility to claim with their health funds. These are Cover Check - a quick way to determine what level of cover a patient has with a fund; and Eligibility Check - to fully check ...
Claims for patients with only one name
Some patients are legally known by a single name. To submit an electronic claim in this situation, enter the name as the family name then enter the text "Onlyname" as the patient's first name. You should be able to verify and submit claims if the ...
Adding a Claimant for Child
Please see the short tutorial video below on how to add a Claimant in CESoft. Claimants are required for children under the of 14 years.
Anaesthetist Assisting at Anaesthesia
To bill for an anaesthetist who assisted at a procedure use Item 25205 (for elective work) or 25200 (if patient is in imminent danger of death). See https://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&qt=NoteID&q=TN.10.9 Also enter the start and ...
What is the Diagnostic Imaging Multiple Service Rule?
Diagnostic imaging items are subject to a multiple services rule. There are 3 rules, A, B and C, which may apply together. Rule A. If 2 or more diagnostic imaging services are provided to a patient on the same day, the fee for the second and ...
Making adjustments to ECLIPSE claims
Once an ECLIPSE claim is submitted electronically, it is generally not possible to make adjustments electronically. Typical reasons for requiring adjustments may include changing date or place of service amending the fees charged adding services that ...
Types of Online Claims
The Health Fund you've selected on an invoice will dictate which claim type (Medicare, DVA or Private Health) is used. This also sets the Fee Calculation to the correct value. Bulk Bill Claims Electronic Bulk Bill claims allow you to claim the MBS ...
Billing Accurately Under Medicare
While the support staff at Cutting Edge are happy to provide general advice about how to correctly bill Medicare for medical services, it's the responsibility of the servicing provider to ensure that all services for their provider numbers are billed ...
Dealing with Rejected Claims
From time to time electronic claims will be rejected. In this case they will appear on the Rejected Claims tab on the ECLIPSE page. The Invoice Status will also get changed to Follow Up, so you can easily locate rejected claims on the Follow Up tab ...
Dealing with Part Paid claims
From time to time electronic claims may only be paid in part. The Invoice Status will be Part Paid, so you can easily locate them on the Part Paid tab in the Invoices listing page. The resolution depends on the cause of the part payment. Here are ...
Adding your Online Claiming Details for BUPA and HBF
BUPA It's important to put your correct BUPA Schedule Type and Payee ID on the Settings/Online screen. You will not be able to transmit claims to BUPA funds until you do. BUPA pays some providers at 100% of MBS; those providers should set MBS as the ...