Medical Billing Backlog Cleanup Australia
Months of unprocessed inpatient billing?
DEVZ Solutions helps Australian specialists organise accumulated billing information, identify outstanding administrative items and establish a consistent workflow for moving forward.
How Medical Billing Backlogs Develop
Billing backlogs can develop for many reasons.
Clinical workload may take priority.
Administrative staff may change.
Billing information may arrive from several hospitals.
Rejected claims may remain unresolved.
A specialist may simply not have enough time between clinical commitments to process everything.
Over time, relatively small amounts of unfinished administration can become a substantial backlog.
What Can Be Included in a Billing Backlog?
A backlog may contain:
- Unprocessed inpatient episodes
- Billing information awaiting submission
- Rejected claims requiring review
- Outstanding payer responses
- Missing administrative information
- Unreconciled payments
- Claims requiring practitioner clarification
- Historical billing requiring assessment
Our Backlog Cleanup Process
DEVZ Solutions can help establish what is outstanding and organise the work systematically.
The process may include:
- Collecting available billing information.
- Categorising outstanding episodes and claims.
- Identifying missing information.
- Separating unsubmitted, rejected and unresolved billing.
- Determining what administrative action is available.
- Processing eligible billing where appropriate.
- Monitoring submitted claims.
- Reconciling outcomes.
- Establishing an ongoing billing workflow.
Historical Claims and Time Limits
Historical billing needs to be assessed individually.
Applicable claiming pathways can have lodgement requirements and time limits.
For example, current Services Australia ECLIPSE guidance states that claims with a lodgement date more than two years after the date of service are not accepted through ECLIPSE.
This does not mean DEVZ Solutions should make assumptions about every historical billing item.
Each outstanding episode should be assessed according to the applicable payer, claiming pathway and circumstances.
Official Information
See the Services Australia ECLIPSE Medical and Eligibility User Guide for Medical Practitioners for official guidance, including the ECLIPSE lodgement rule discussed above.
From Backlog to Ongoing Workflow
Cleaning up old billing solves only part of the problem.
The longer-term objective is to prevent another backlog developing.
DEVZ Solutions can transition from backlog administration into an ongoing specialist billing workflow covering:
- Processing
- Claim submission
- Monitoring
- Reconciliation
- Administrative follow-up
This creates continuity between clearing historical work and managing future inpatient billing.
No Judgement — Just an Organised Process
Billing backlogs happen in busy medical practices.
The objective is not to determine why work accumulated.
The objective is to establish what remains outstanding, determine what administrative action is available and create an organised process for moving forward.
Talk to DEVZ Solutions About Your Backlog
Medical Billing Backlog FAQs
Can DEVZ Solutions help with months of unbilled work?
DEVZ Solutions can help organise accumulated billing information and determine what administrative action may still be available for individual outstanding items.
Is there a time limit for old medical claims?
Time limits and lodgement requirements depend on the applicable claiming pathway and circumstances. Current Services Australia ECLIPSE guidance states that claims lodged more than two years after the service date are not accepted through ECLIPSE.
Can every old claim still be paid?
No guarantee should be made. Claimability and payment depend on the individual service, available information, payer requirements, applicable time limits and assessment outcome.
Can DEVZ Solutions take over ongoing billing after cleaning the backlog?
Yes. Backlog administration can transition into an ongoing specialist inpatient billing workflow.