Inpatient Medical Billing for Australian Specialists
DEVZ Solutions specialises in billing for admitted hospital patients across Australia. Inpatient work can involve Medicare, private health insurers, ECLIPSE, gap schemes, public/private patient status, multiple providers and claim follow-up — which is why dedicated inpatient billing expertise matters.
Inpatient is our core specialty
DEVZ uses its own secure, Medicare- and ECLIPSE-compliant billing software. You securely send us the authorised billing information; we prepare, lodge, monitor and reconcile the claims. We do not need to remotely log into your practice software.
Public patients in public hospitals
For Medicare-eligible Australians, core treatment as a public patient in a public hospital is provided under public funding arrangements without an out-of-pocket charge for the public hospital treatment. This is a different billing pathway from treating a person as a private patient.
Private patients in public or private hospitals
A private patient may be treated in a private hospital or elect private treatment in a public hospital. For eligible in-hospital doctor and specialist services, Medicare generally covers 75% of the MBS fee and private health insurance covers at least 25%. The doctor's actual fee may be higher than the MBS fee, so an out-of-pocket gap can still arise.
Can inpatient services be bulk billed?
Yes. Bulk billing describes how an eligible Medicare service is paid; it does not mean the service was outpatient. Current Department of Health guidance specifically addresses bulk-billed services in hospital settings for private patients. Public-patient hospital services remain governed by separate public funding rules. Read the specialist bulk-billing guide.
No-gap and known-gap arrangements
Private health insurers may offer gap-cover arrangements. Under a no-gap arrangement, an eligible service can leave the patient with no medical gap under the scheme. Under a known-gap arrangement, a limited patient gap may apply subject to the fund's rules, the provider's participation and patient eligibility. No Gap vs Known Gap.
ECLIPSE and Simplified Billing
Services Australia uses ECLIPSE for paid and unpaid inpatient medical claims, billing-agent claims, patient claims, Simplified Billing, patient verification and eligibility checking. ECLIPSE medical billing guide.
Informed financial consent
Private patients should understand expected fees and likely out-of-pocket costs before treatment. Written estimates and appropriate eligibility information help support informed financial consent. Informed Financial Consent.
How DEVZ handles inpatient billing
- Receive authorised patient, provider and service information securely.
- Prepare the claim using the doctor's billing instructions and applicable claiming pathway.
- Lodge eligible Medicare, ECLIPSE and private health fund claims.
- Monitor responses and follow up rejected, delayed or unresolved claims.
- Reconcile payment outcomes against the billing record.
Our service focuses on inpatient billing
Inpatient remains our specialist focus, but DEVZ can also manage outpatient private and bulk-billed work when required, particularly for new or solo doctors who do not have dedicated billing staff. Outpatient medical billing.
Frequently asked questions
Can an inpatient service be bulk billed?
Yes, where the service is eligible and Medicare rules permit bulk billing in that private-patient hospital setting.
How do Medicare and private health funds split an eligible private inpatient service?
Medicare generally covers 75% of the MBS fee and private health insurance covers at least 25% of the MBS fee. Any fee above the combined benefit may create a gap.
Does DEVZ only do inpatient billing?
Yes. DEVZ provides inpatient billing administration; outpatient topics appear in our education library but are not services we currently administer.