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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 manages billing, claims, payments, reconciliation, reporting and recovery across outpatient, inpatient, hospital and hybrid environments. Supported claim types include Medicare online, DVA, private health claims through ECLIPSE, patient claiming (PCI), Inpatient Medical Claims (IMC), In-Hospital Claims (IHC), third-party funding and self-funded billing. Billing tools cover multi-payer accounts, invoices and estimates, adjustments and reversals, EFTPOS and digital payments, batch submission and tracking, and revenue and debtor reporting. Automated reconciliation compares expected and actual payments, while exception workflows support correction and resubmission of rejected or partial claims. Organisations can configure rate tables, fee schedules, billing codes and payer rules without redevelopment. Full billing and claiming is included; the optional Billing Wizard adds rule-based invoice validation, claim routing, payer-specific rules, exception handling and reconciliation checkpoints. The module lists HL7, FHIR and JSON/REST APIs for system connections, as well as an audit trail and compliance controls. CareRight says it hosts the service on Amazon Web Services and stores data in Australia. Clintel describes implementation support that can include discovery, configuration, integration, training, go-live assistance, transitional hypercare and ongoing SLA-based support.
Who it suits
CareRight Billing and Claiming suits Australian outpatient, inpatient, hospital and hybrid billing environments. Its multi-payer support and configurable billing rules are relevant to multi-site and high-volume organisations managing different claim types and payment workflows.
What it does well
- Supports Medicare online, DVA, ECLIPSE, PCI, IMC and IHC claims.
- Automates reconciliation and supports rejected-claim correction and resubmission.
- Configure payer rules, rate tables and billing codes without redevelopment.
- Includes a full audit trail and compliance controls.
- Lists HL7, FHIR and JSON/REST API connections.
What to know first
- Pricing is available on request.
- The listed platform is web only.
- Billing Wizard automation is optional.
Limits
The optional Billing Wizard is not part of the stated out-of-the-box capability. Pricing is available on request.
Getting started
- Visit the CareRight Billing and Claiming website.
- Use the web-based platform.
- Contact CareRight for pricing and implementation details.
- Implementation support can include discovery, configuration, integration and training.
- Go-live assistance, transitional hypercare and ongoing SLA-based support are described for implementations.
Verdict
Choose CareRight Billing and Claiming if your Australian healthcare organisation needs multi-payer billing, claim management and reconciliation in one web-based module. The optional Billing Wizard is the route to its additional rule-driven automation. Pricing is available on request.
Questions
How is CareRight Billing and Claiming priced?
It is paid software, with pricing on request.
What claim types does it support?
Supported types include Medicare online, DVA, private health claims through ECLIPSE, patient claiming (PCI), IMC, IHC, third-party funding and self-funded billing.
What platforms does it support?
The listed platform is web, and CareRight describes its clinic suite as web-based.
Is Billing Wizard included?
Full billing and claiming capability is included out of the box. The optional Billing Wizard adds configurable automation for validation, routing, payer rules and reconciliation checkpoints.
What integrations does the module list?
It lists HL7, FHIR and JSON/REST APIs for connecting with other systems.
Where is CareRight data hosted?
CareRight says it uses Amazon Web Services for hosting and stores data in Australia.
Facts from CareRight Billing and Claiming's own pages
- Billing features
- Features include multi-payer accounts, invoicing and estimates, adjustments and reversals, EFTPOS and digital payments, batch submission and tracking, and revenue and debtor reporting. · careright.au, 8 Oct 2026
- Billing Wizard
- Full billing and claiming capability is included out of the box; the optional Billing Wizard adds configurable automation for invoice validation, claim routing, payer rules, and reconciliation checkpoints. · careright.au, 8 Oct 2026
- Claim types
- It supports Medicare online, DVA, private health claims through ECLIPSE, patient claiming (PCI), Inpatient Medical Claims (IMC), In-Hospital Claims (IHC), and third-party funding. · careright.au, 8 Oct 2026
- Configurable workflows
- Rate tables, fee schedules, billing codes, and payer rules can be configured without redevelopment. · careright.au, 8 Oct 2026
- Configuration
- Rate tables, fee schedules, billing codes and payer rules can be configured without redevelopment. · careright.au, 8 Oct 2026
- Founded
- 2006 · careright.au, 28 Sept 2026
- Headquarters
- Kent Town, South Australia, Australia · careright.au, 28 Sept 2026
- Hosting and data location
- CareRight’s website says it uses Amazon Web Services for hosting and stores data in Australia. · careright.au, 8 Oct 2026
- Implementation and support
- Clintel describes discovery, configuration, integration, training, go-live assistance, transitional hypercare and ongoing SLA-based support for implementations. · careright.au, 8 Oct 2026
- Integrations
- The billing module lists HL7, FHIR and JSON/REST APIs for connecting with other systems. · careright.au, 8 Oct 2026
- Intended users
- The billing module is described for outpatient, inpatient, hospital and hybrid billing environments, including multi-site, multi-payer and high-volume organisations. · careright.au, 8 Oct 2026
- Optional automation
- The optional Billing Wizard adds rule-driven invoice validation, claim routing, payer-specific billing rules, exception handling and reconciliation checkpoints. · careright.au, 8 Oct 2026
- Payers
- It supports Medicare online claiming, DVA, private health insurance via ECLIPSE, patient claiming (PCI), third-party and self-funded billing. · careright.au, 8 Oct 2026
- Platform
- CareRight describes its clinic suite software as web-based. · careright.au, 8 Oct 2026
- Purpose
- CareRight Billing & Claiming is a revenue cycle platform for Australian healthcare that manages billing, claims, payments, reconciliation, reporting and recovery. · careright.au, 8 Oct 2026
- Reconciliation and recovery
- The platform supports automated reconciliation, expected-versus-actual payment comparisons, exception workflows, and correction and resubmission of rejected or partial claims. · careright.au, 8 Oct 2026
- Security and audit
- The billing page states that the module includes a full audit trail and compliance controls. · careright.au, 8 Oct 2026
- Security and compliance
- Clintel's information security statement names the Privacy Act 1988, Healthcare Identifiers Act 2010, and Health Insurance Act 1973 among the laws and regulations it says it adheres to. · careright.au, 8 Oct 2026
- Web access
- CareRight describes its clinic suite software as web-based. · careright.au, 8 Oct 2026
Where CareRight Billing and Claiming stands on Freedom251
- Medical Billing Software#21 of 28