CareRight Billing and Claiming

What CareRight Billing and Claiming is

CareRight Billing and Claiming is a web-based revenue-cycle platform for Australian healthcare organisations. It handles billing, claims, payments, reconciliation, reporting, and recovery for outpatient, inpatient, hospital, and hybrid settings. Supported routes include Medicare online, DVA, private health claims through ECLIPSE, patient claiming, Inpatient Medical Claims, In-Hospital Claims, third-party funding, and self-funded billing. Features cover multi-payer accounts, invoices and estimates, adjustments, reversals, EFTPOS and digital payments, batch submission and tracking, and revenue and debtor reporting. Automated reconciliation compares expected with actual payments, while exception workflows support correction and resubmission of rejected or partial claims. Rate tables, fee schedules, billing codes, and payer rules can be changed without redevelopment. Billing and claiming are included out of the box; the optional Billing Wizard adds rule-based validation, routing, payer rules, exception handling, and reconciliation checkpoints. HL7, FHIR, and JSON/REST APIs support connections. The module includes an audit trail and compliance controls, with Australian AWS-hosted data.