Claims Management

The Claims Management Dashboard allows you to manage, review, and reconcile Support at Home claims against Services Australia payment statements. It supports the claiming workflow, from uploading payment statements and reviewing variances to finalizing claims and generating statement files.

This article provides an overview of the key sections and functionalities of the dashboard, including Claims Management, Statement Periods, and Claim ID details. For detailed workflows, please refer to the Related Articles section below.

Keywords: claims management dashboard, support at home claims, carevision claims, services australia reconciliation, claim id management, payment statement processing, claim reconciliation, aged care billing, statement periods, funding reconciliation

Key Support at Home Files

File	Description
Support at Home Claim File (CareVision)	Generated from CareVision with invoice references aligned to the finance system and grouped under a claim ID for reconciliation. Submitted to Services Australia.
Support at Home Payment Statement (Services Australia)	Record of claims, payments, adjustments, and held amounts for a selected period, with item-level details. Available in CSV, XML, or PDF.
Support at Home Statement File	Generated after claim finalization, grouping claims into a statement period, recalculating funding, and producing statements for distribution.
Invoice File	Generated after claim validation is complete and contains funded invoices for the finance system and co-payment invoices for clients, based on the selected export format (Example: DEX CHSP, Xero, MYOB, Epicor, TechOne)

Related Articles

1. Support at Home Billing and Claiming Workflow
2. How to Generate SAH Statements
   

I. Claims Management Section

This section is where you upload the Support at Home Payment Statement (Services Australia) to allow automated reconciliation and validation of claims against CareVision data.

A. How to Access

The Claims Management Dashboard is available in the portal under Actions > Claims Management in the left navigation pane. This dashboard allows you to review claim records and upload payment files for each claim.

Expand the Dashboard View

To analyze large volumes of claims easily, click the gray arrow in the lower-left corner of the screen to expand the Claims Management Dashboard to full-screen mode.

Refreshing Claim Data

Use the Refresh button at the top of the dashboard to update and view the latest claim information.

B. Key Columns

Column	Description
Claim ID	Unique identifier for each claim.
Export ID	Identifier linked to the exported claim file, generated when the claim file is marked as "Final" in the Billing Exports History section. You can expand or collapse the Export ID column by clicking the “eye” icon. When expanded, the following columns are shown: Gauges, Period, Created By, Created Date.
Provider	The name of the program related to the claim, such as SAH.
Outlet ID	A unique code that identifies and links specific transactions to a particular outlet location within your organization.
Delivery Period Start Date	The start date of the period in which services were delivered, in the format DD-MM-YYYY
Delivery Period End Date	The end date of the period in which services were delivered, in the format DD-MM-YYYY
Adjustment From Date/Time	The start of the adjustment window, indicating when changes such as late approvals, cancellations, or corrections begin to be captured in the claim, in the format DD-MM-YYYY HH:MM AM/PM. Example: 30-01-2026 12:00 AM
Adjustment To Date/Time	The end of the adjustment window, indicating the cut-off point up to which changes are included in the claim, in the format DD-MM-YYYY HH:MM AM/PM Example: 02-02-2026 12:00 AM
Gauges	Visual indicators that show the status and progress of items within a claim based on variances and actions taken. The gauge updates as items are processed, helping track progress toward finalisation. Purple: Amendments Pink: Disputed Blue: Accepted Yellow: Unprocessed with variances Green: No variances
Period	The statement period the claim is assigned to.
Created By	Name of the person who created the claim entry.
Created Date	Date when the claim was initially created in the system.
Status and Actions	This column displays the current processing status of a claim and provides the available actions based on that status.
Status	Description
Pending	The payment statement has not yet been uploaded, and the claim has not started reconciliation.
Processing	The payment statement has been uploaded, and the claim is under review with outstanding variances or actions to resolve.
Final	All claim items have been reviewed and resolved, and the claim is ready for invoice generation and statement processing.

C. Key Actions

Upload Payment File

Click Upload Payment File to upload the payment statement file received from Services Australia for reconciliation.

Select the correct file from your computer and click Upload. The claim status will update to Processing, which means your team can now begin processing the claim.

Finalize

Click Finalize to mark the claim as final once all variances are processed and accepted, which locks the claim from further editing.

Unfinalize

Click Unfinalize if you want to revert a claim from Final to an editable state and allow further changes; this option is available only when the claim status is Final.

Download Invoice File

Click Download Invoice File if you want to generate invoice files for finalized claims in the required format.

Select the appropriate export format for your finance system (Example: Dex CHSP File, Xero Invoices, MYOB, Epicor, or TechOne).  For example, TechOne, this will generate both the government invoices and the co-contribution invoices.

 

Choose the required file extension (.son or .xml) before downloading.

Click Download

Assign to Period

Click Assign to Period to assign a finalized claim to a statement period for statement generation; this option is available only for Final claims.

Related Article:

How to Generate SAH Statements

Remove Period

Click Remove Period if you want to remove a claim from a statement period and allow it to be reassigned if needed.

Remove Claim

Click Remove Claim if you want to remove a claim before finalization; this option is not available once the claim is marked as Final.

D. Gauges

Gauges

You can see gauges that visually indicate the status of items within each claim. The color changes based on how many items matched with no variance, how many have variances, and how many variances have been processed.

As you work through the claim, the gauge updates to reflect your progress and helps you track how close you are to finalizing the claim.

• Purple: Amendments
• Pink: Disputed
• Blue: Accepted
• Yellow: Unprocessed with variances
• Green: No variances

II. Statement Periods Management Section

This section is where the Support at Home Statement File is generated by grouping finalised claims into a statement period. It allows you to recalculate funding and produce statements for distribution.

A. How to Access

How to Access

Go to Actions > Claims Management, and then click Statement Periods Management at the top of the page.

B. Key Columns

Column	Description
Period Date	Displays only periods that have associated claims. A claim must be finalized and assigned to a period to appear. Each claim can be assigned to one period only.
Claim IDs	Lists all claim IDs assigned to the period. Clicking a claim ID opens detailed claim information in a new tab.
Status	Indicates the state of the period: Open (editable, allows recalculation and statement generation) or Closed (locked, no further changes allowed).
Modified Date	The most recent date when the period or its associated data was updated.
Modified By	The user who last modified the period or performed an action on it.
Funding Generated Date	The date when funding was generated.
Actions	Provides options to manage the period, including recalculating funding, generating statements, downloading statements, and finalizing the period.

C. Key Actions

Re-calculate Funding on Period

Click Re-calculate Funding on Period to refresh funding data for all claims and clients within the period. We recommend that you use this after updates to funding or client profiles.

Generate Statement

Clicking Generate Statement generates a zip file of client statements for open periods, reflecting the latest funding data.

Download Statement

1. Download Statement button: You can use this button for closed periods to download the final statements. You cannot generate new statements or recalculate funding for closed periods because the data is locked.

Finalize & Send Statement

Click the Finalize & Send Statement button to lock the period and prepare statements for distribution.

Note: This action will not email the Statements to your clients. Instead, it will download a zip file containing the Statements, which you can then send or print as needed.

III. Claim IDs Section

This section provides a detailed, item-level view of a claim, comparing CareVision claim data with the Services Australia payment statement for reconciliation.

A. How to Access

Click any Claim ID.

The detailed information for that claim will open in a new tab.

B. Key Columns

Column	Description
ID	Unique identifier for the claim line item, used to reference specific billing entries.
Client Name	Name of the individual receiving Support at Home services.
Care Recipient	Unique ID of the care recipient.
Delivery Date	Date the service was delivered.
CV Service Name	Service name as recorded in CareVision.
Line Item Description	Description entered in the manual line item template.
Budget Type	Indicates which budget the service is drawn from.
Allocation Category Code	Code representing the funding category. Expand to view breakdown: ON (Home Support Ongoing) AT (Assistive Technology) CM (Care Management) EL (End of Life) HM (Home Modifications) RC (Restorative Care) AS (Assistive Technology - Specified Needs)
Breakdown of Budget Allocations	Shows how funding is distributed across categories, including participant contribution amounts.
Service Identifier	Unique service code (format: SERV-XXXX).
Service Type Identifier	Unique service type code (format: SERT-XXXX).
Service Group	Groups related services (Example: Home Support, Assistive Technology).
Service Type	Service type aligned with Services Australia (Ref 33).
Service Name	Official service name matching Services Australia and CareVision billing.
Item Code	Unique item identifier (Ref 30), aligned with SAH Business Service ID.
Item Description	Descripton from the manual line item template.
Wrap Around Code	Code for additional or wraparound services.
Wraparound Description	Description of wraparound support provided.
Entitlement Type	A classification that identifies the status of a claim.
Current	The entitlement that is currently active and being claimed
Previous	An entitlement that was claimed or applied in the past.
Amendment	A change or update made to an existing entitlement (Example: correcting or adjusting a prior claim).
Rate	Rate applied per unit of service.
Quantity	Number of units delivered.
Unit	Unit of measure (Example: hours, visits).
Invoice Amount	Total amount invoiced for the claim line. Calculation: Invoice Amount = Rate × Quantity
Compensation Reduction	Displays final value or variance for compensation adjustments.
Compensation Reduction – Govt Calculated	Value from payment file (CSV PaymentItems column 25).
Compensation Reduction – CV Calculated	Currently set to 0 (not calculated).
Compensation Reduction – Variance	Difference between government and CV values. Calculation: Compensation Reduction Variance = (Compensation Reduction Govt Calculated) − (Compensation Reduction CV Calculated)
Compensation Reduction – Final	Final value based on reconciliation outcome.
Individual Contribution	Displays the final value where available; otherwise, displays the variance between calculated values.
Individual Contribution - Govt Calculated	Value sourced from payment file [CSV - PaymentItems], column 26 ($fields[25]).
Individual Contribution - CV Calculated	Calculated individual contribution amount based on defined rules using expected_remaining_co_contribution, previous_remaining_co_contribution, and allocated_co_contribution_amount.
Individual Contribution - Variance	Calculation: Individual Contribution Variance = (Individual Contribution Govt Calculated) − (Individual Contribution CV Calculated)
Individual Contribution Final	This value displays either the CV-calculated or government-calculated amount, depending on the reconciliation status: If reconciliation status is disputed, then the CV-calculated value is used If reconciliation status is accepted or no variance, then the Government-calculated value is used
Fee Reduction	Displays the final value where available; otherwise, displays the variance between calculated values.
Fee Reduction - Govt Calculated	Value sourced from payment file [CSV - PaymentItems], column 30 ($fields[29]).
Fee Reduction - CV Calculated	Value currently set to 0 (not computed).
Fee Reduction Variance	Difference between government and CV calculated values. Calculation: Fee Reduction Variance = (Fee Reduction Govt Calculated) − (Fee Reduction CV Calculated).
Fee Reduction Final	This value displays either the CV-calculated or government-calculated amount, depending on the reconciliation status: If reconciliation status is disputed, then the CV-calculated value is used If reconciliation status is accepted or no variance, then the Government-calculated value is used
Reduction Type	Displays the final value where available; otherwise, displays the variance between calculated values.
Reduction Type - Govt Calculated	Value currently null (not available).
Reduction Type - CV Calculated	Value currently null (not available).
Reduction Type Variance	Difference between government and CV calculated values. Calculation: Reduction Type Variance = (Reduction Type Govt Calculated) − (Reduction Type CV Calculated).
Reduction Type Final	This value displays either the CV-calculated or government-calculated amount, depending on the reconciliation status: If reconciliation status is disputed, then the CV-calculated value is used If reconciliation status is accepted or no variance, then the Government-calculated value is used
Payment Determination	Displays the final value where available; otherwise, displays the variance between calculated values.
Payment Determination - Govt Calculated	Value sourced from payment file [CSV - PaymentItems], column 27 ($fields[26]).
Payment Determination - CV Calculated	Calculated payable amount after co-contribution. Calculation: ($claimDetail['quantity'] * $claimDetail['rate']) - $claimDetail['actual_co_contribution']
Payment Determination Variance	Difference between government and CV calculated values. Calculation: Payment Determination Variance = (Payment Determination Govt Calculated) − (Payment Determination CV Calculated).
Payment Determination Final	This value displays either the CV-calculated or government-calculated amount, depending on the reconciliation status: If reconciliation status is disputed, then the CV-calculated value is used. If reconciliation status is accepted or no variance, then the Government-calculated value is used.
Budget Drawn Down	Displays the final value where available; otherwise, displays the variance between calculated values.
Budget Drawn Down - Govt Calculated	Value sourced from payment file [CSV - PaymentItemBudget], column 4 ($fields[3]).
Budget Drawn Down - CV Calculated	Calculated budget usage based on service delivery. Calculation: $claimDetail['rate'] * $claimDetail['quantity']
Budget Drawn Down Variance	Difference between government and CV calculated values. Calculation: Budget Drawn Down Variance = (Budget Drawn Down Govt Calculated) − (Budget Drawn Down CV Calculated).
Budget Drawn Down Final	This value displays either the CV-calculated or government-calculated amount, depending on the reconciliation status: If reconciliation status is disputed, then the CV-calculated value is used. If reconciliation status is accepted or no variance, then the Government-calculated value is used.
Final Determination	Displays the final value where available; otherwise, displays the variance between calculated values.
Final Determination - Govt Calculated	Value sourced from payment file [CSV - PaymentItems], column 28 ($fields[27]).
Final Determination - CV Calculated	Calculated final payable amount after co-contribution. Calculation: ($claimDetail['quantity'] * $claimDetail['rate']) - $claimDetail['actual_co_contribution']
Final Determination Variance	Difference between government and CV calculated values. Calculation: Final Determination Variance = (Final Determination Govt Calculated) − (Final Determination CV Calculated).
Final Determination Final	This value displays either the CV-calculated or government-calculated amount, depending on the reconciliation status: If reconciliation status is disputed, then the CV-calculated value is used. If reconciliation status is accepted or no variance, then the Government-calculated value is used.
Reconciliation Status	Indicates the reconciliation outcome and determines which calculated value is used.

C. Key Actions

Accept

Click Accept to confirm you agree with the value given by the government, as reflected in the Support at Home (SAH) payment statement file from Services Australia. If no action is taken (no Accept or Dispute), the system will automatically accept this value.

Use Claim Value and Dispute

Click Use Claim Value and Dispute to indicate you do not agree with the value given by the government (as reflected in the SAH payment statement file) and will instead use CareVision’s calculated claim value.

Dispute and Do Not Include

Click Dispute and Do Not Include to reject the value given by the government and exclude the claim from the Support at Home Statement File.

Add Notes

1. Add Notes: You can now add explanatory notes directly to a claim. 
   

1. This functionality makes it easy to document important information within the claim record, helping your team keep all relevant details organized and accessible for future reference and collaboration.

View Client Funding

Click View Client Funding to view the client’s funding details. 

You will be redirected to the client profile, specifically the Funding Sources section.

 D. Reconciliation Status

Reconciliation Status	Description
Accepted	The government-calculated value is used as the final value.
Excluded	The claim is excluded from the Support at Home Statement File and not included in reporting.
No Variance	No difference exists between government and CareVision calculated values.
Disputed	The CareVision-calculated value is used as the final value instead of the government value.
Pending	The claim has not yet been reviewed or finalised.
Adjustment	Applies to Amendment or Previous entitlement types, indicating a revised or historical claim.

Related Articles

1. Support at Home Billing and Claiming Workflow
2. How to Generate SAH Statements
3. Handling Negative Claim Adjustments from Service Cancellations
4. Handling Claims with Multiple Budget Allocations and Contributions
5. Handling Claims with Underpayment (With Co-Contribution)
6. Handling Claims with Underpayment (No Co-Contribution)

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