Lumary AC - This article explains how to upload the Payment Statement file for an Support At Home (SAH) bulk claim.
Once Services Australia processes your claim, Services Australia will provide a Payment Statement file. This is the file that shows the amount that was paid for each claimed invoice item. To align your records to your paid SAH claims, you can upload the Payment Statement file.
The payment statements will be published on the Aged Care Provider Portal (ACCP) once claims have been finalised and payments made.
Required packages and permissions
Available with: Lumary AC 2.11 and later
When you open your extract record, the SAH Claim Process Tracker will show you where you're up to in the claiming process. You should be at step 4. Results Uploaded.
This article allows you to efficiently manage Payment Statements:
Upload Payment Statement
Select and upload your Payment Statement file into Lumary for reconciliation.
To upload the Payment Statement file:
- Go to the Claims tab.
- Click on the Generate Claim button at the top left of the claims page. You may need to use the drop-down arrow to find this option.
- Click Upload Files and locate the Payment Statement file on your computer, or drag and drop the file onto the Or drop files area.
- Once the file has loaded, click on the Generate Claim button.
Now you've successfully uploaded the Payment Statement file, Lumary will process it to create or update relevant records
Processing of Payment Statement
Lumary automatically processes the Payment Statement file, creating or updating Claim, Payment Items, and Payment Item Budgets.
When Lumary processes the Payment Statement file, we will determine whether a Claim record already exists for the given Claim Identifier or if a new Claim record needs to be created. The uploaded Payment Statement file will be saved in the Files section on the claim, and you will be automatically redirected to the relevant claim record.
The workflow differs depending on:
- A Claim record with the same Claim Identifier was found, or
- No existing Claim record matches the Claim Identifier.
Regardless of the scenario, Lumary will:
- match Extract Items to Payment Items using the Item External Reference Identifier to update the status of related Extract and Extract Item,
- create a Payment Item record for every Payment Item in the Payment Statement file,
- create Payment Item Budget records for each Payment Item Budget in the file, and
- create or update associated Journal Entries for each Payment Item.
Existing Claim Record Updated
When a Claim Record's Claim Id matches the Claim Identifier in the Payment Statement file, Lumary links the new payment statement data to the existing claim record. All details in the Payment Statement file will override and replace any existing Payment Item and Payment Item Budget Records.
The table below shows which details from the Payment Statement file the Claim record will be updated with:
| Field | Source |
|---|---|
| Payment Date |
Payment Date from Payment Statement File. |
| Status | Completed |
| Payment Statement CSV | True |
New Claim Record Created
When no Claim Record matches the Claim Identifier from the Payment Statement file. A new Claim will be created from the Payment Statement file as per the below table:
| Field | Source |
|---|---|
| Claim Id |
Claim Identifier from Payment Statement File. |
| Payment Date |
Payment Date from Payment Statement File. |
| Service NAPS Id |
Service Naps Identifier from Payment Statement File. |
| Service Provider Id |
Registered Provider Identifier from Payment Statement File. |
| Site | Site record that matches the Service Naps Identifier |
| Status | Completed |
| Payment Statement CSV | True |
Extract Item Updates
During processing of the Payment Statement file, Lumary matches Extract Items to Invoice Items using the Item External Reference Identifier. Lumary will automatically update the status of related Extract and Extract Item records. Extracts SvA Invoice Status are marked as ‘COMPLETED’, and Extract Items Invoice Item Status are set to ‘PAID’ with their claim status updated to ‘Paid’. This ensures accurate and up-to-date tracking of claim payments.
Payment Item Creation
During processing of the Payment Statement file, Lumary will create a Payment Item record for every Payment Item in the Payment Statement file, the below table shows each of the fields captured from Payment Statement File.
| Field | Purpose |
|---|---|
| Claim | The claim the payment item is related to |
| Invoice Id | The unique identifier for an invoice |
| Item Id | Identifier to identify the particular item within an invoice. |
| Invoice External Reference Id | An external identifier to distinguish an invoice within Lumary. |
Invoice Item External Reference Id |
An external identifier to distinguish this invoice items within Lumary. |
| Care Recipient Id | The identifier of a person who has been assessed to be requiring Residential Care, Transition Care or Support at Home |
| Care Recipient First Name | The first name or given name of the Care Recipient |
| Care Recipient Last Name | The last name or surname of Care Recipient |
| Delivery Date | The date the service was delivered on. |
| Service Group Id | The group the service being delivered and invoiced belongs to. |
| Service Group Text | The text of the Service Group Identifier |
| Service Type Identifier | The type of service being delivered and invoiced. |
| Service Type Text | The text of the Service Type Identifier |
| Service Identifier | The service being delivered and invoiced. |
| Service Text | The text for the Service Identifier |
| Item Description Code | The item code of the service being delivered. |
| Item Description Text | The text description of the item being delivered. When item description code is Other, the free text description will be returned in this field. |
| Wraparound Description Code | The wraparound code of the service being delivered. |
| Wraparound Description Text | The text description of the wraparound service being delivered. When wraparound description code is Other, the free text description will be returned in this field. |
| Entitlement Type | Denotes if this is a current (original) invoice item claimed, adjustment to an original (previous) invoice item claimed or amendment for a previous invoice claimed. |
| Quantity | The quantity of units of this item provided. |
| Price Per Unit | Amount charged per unit. |
| Unit Type | The unit of measure referred to in quantity |
Invoice Amount |
The amount claimed for the cost of delivering the service to the care recipient. Negative values may display for Adjustment or Amendment types. |
Compensation Reduction |
Compensation amount to be reduced from the payment determination. Represents the amount that will be covered by a third party compensation arrangement. |
Individual Contribution Amount |
Individual contribution to be reduced form the payment determination. Represents the amount the care recipient needs to contribute to the cost of the service delivered. |
AT/HM Reduction |
Individual contribution (calculated by mean assessment) to be reduced from the payment determination |
Fee Reduction |
Individual contribution (calculated by mean assessment) to be reduced from the payment determination |
Reduction Type |
The reason for the individual contribution reduction e.g. hardship. |
Payment Determination |
Amount determined as payable. |
Final Determination |
The final amount after adjustments or amendments have been applied to the invoice item. |
Payment Item Budget Creation
During processing of the Payment Statement file, Lumary will store and track the payment item budget related to a payment item. Multiple budgets can be drawn down for a single payment item, the below table shows each of the fields captured from Payment Statement File.
| Field | Purpose |
|---|---|
| Payment Item | The payment item the payment item budget is related to |
| Budget Type Code | The code of Budget Type. |
| Budget Type Text | Service Provider and care recipient budget types used as the source of funding for the service delivered |
| Amount | The amount drawn down from one or more budgets applicable to the invoice item. |
Related Journal Entry |
Lookup to the Journal Entry record created or updated for this Payment Item Budget. |
Journal Entry Creation
Available with: Lumary AC 2.11 and later
When the Payment Statement file is processed, Lumary will create or update relevant Journal Entries records for each Payment Item Budget within the file. This will ensure that all Payment Item records are accurately reflected in Journal Entries to support variations for the Monthly Statements.
When the Payment Statement file is processed, Lumary creates or updates a Journal Entry record for each Payment Item Budget within the file. This is based on the scenarios:
- No Existing Journal Entry for the Invoice Item
- Creates a new Journal Entry using the details from the Payment Item.
- This ensures that every Payment Item has a corresponding Journal Entry for proper accounting.
- Existing Journal Entry Found for the Invoice Item
- Journal Entry is Unlocked
- Update the existing Journal Entry with the new values from the Payment Item.
- This allows adjustments to be reflected directly in the original Journal Entry.
- Journal Entry is Locked
- Create a new Journal Entry containing only the delta values (the differences from the Payment Item).
- This will be marked as a variation, as appropriate, to indicate any adjustments or refunds from previous months to be included in the client’s monthly statement.
- This preserves the original locked entry while capturing any changes.
- Journal Entry is Unlocked
New / Updated Journal Entries
The following table shows how data is used to populate fields on the created or updated Journal Entry record.
| Field | Source |
|---|---|
| Account |
|
| Date |
Delivery Date from Payment Statement File |
| Date Paid |
Payment Date from Payment Statement File |
| Credit |
When Payment Item
|
| Debit |
When Payment Item
|
| Particulars | Invoice and Invoice Item Ids e.g. Invoice: EXT-000860, Item: EXI-07157 |
| Service Delivered | Related Service Delivered |
| Quantity | Quantity from Service Delivered |
| Invoice Item Extract Item | Related Extract Item |
| Individual Contribution Amount |
Individual Contribution Amount from Payment Statement File |
| Variation | False |
Variation Journal Entries with Delta
Indicates any adjustments or refunds from previous months to be included in the client’s statement.
When processing Payment Items, Lumary calculates deltas to capture any changes or adjustments. This ensures that statements accurately reflect updates, including adjustments or refunds from previous months. The deltas are calculated based on the below table
| Delta Type | Current Journal Entries | Payment Item Budget | Delta Calculation |
|---|---|---|---|
| Amount | Total Amount of existing Journal Entries | New or updated Payment Item Budget Amount | Payment Item Budget Amount - Current Journal Entries Amount |
| Quantity | Total Quantity of existing Journal Entries | New or updated Payment Item Quantity | Payment Item Budget Quantity - Current Journal Entries Quantity |
| Individual Contribution | Total Individual Contribution of existing Journal Entries | New or updated Payment Item Individual Contribution | Payment Item Budget Individual Contribution - Current Journal Entries Individual Contribution |
The following table shows how data is used to populate fields on the created variation Journal Entry record.
| Field | Source |
|---|---|
| Account |
|
| Date |
Delivery Date from Payment Statement File |
| Date Paid |
Payment Date from Payment Statement File |
| Credit |
If Amount Delta is positive number
|
| Debit |
If Amount Delta is negative number
|
| Particulars | Invoice and Invoice Item Ids e.g. Invoice: EXT-000860, Item: EXI-07157 |
| Service Delivered | Related Service Delivered |
| Quantity | As calculated Quantity Delta |
| Invoice Item Extract Item | Related Extract Item |
| Individual Contribution Amount | As calculated Individual Contribution Delta |
| Variation | False |
The SAH Claim Process Tracker will be at step 5. Payment Statement Uploaded. The process will be complete.