About eClaims
- Details
The current claim submission process from Healthcare Providers to Insurers is primarily paper-driven. eClaims or electronic claiming automates this process.
The eClaims project aims to address the following key problems:
- The current paper-driven process in Ireland is non-standard, time-consuming and, due to its manual nature, leads to a higher propensity for error.
- The inaccuracy of data handled through the paper process often leads to claims being returned, pended and rejected unnecessarily. eClaims enables immediate detection of incomplete submissions.
- The claims reconciliation process is not standardised across the industry, leading to further inefficiencies
The project encompasses 2 key phases as follows:
Phase 1 - the submission of claims electronically from healthcare providers to health insurers
- Stage 1: saw the definition of the industry standard to support eClaims in Ireland. This stage is complete and the eClaims standard documentation is available on the ‘Publications’ page on this website.
- Stage 2: saw the successful pilot of the eClaims Submission Standard by two private healthcare providers - Euromedic Ireland and the Beacon Hospital. Both providers are now submitting live eClaims to the Insurers.
- Stage 3: aims to rollout the eClaims Submission Standard to other healthcare providers. The rollout phase is well underway and further participant information will be issued shortly. We welcome enquiries from other interested parties.
Phase 2 - the remittance of claims electronically
- The key objective of this phase will be to rollout an industry standard for Status & Remittance to all healthcare providers. Further announcements on this phase will be published in due course.




