SAH gap payments

How Visualcare identifies and manages payment gaps in Support at Home claims

When Services Australia doesn’t pay the full amount of a submitted Support at Home (SAH) claim, Visualcare identifies the shortfall and helps you determine whether an invoice is needed and who to bill.

What is a gap payment?

A gap payment is the difference between what you claimed and what Services Australia paid. This can occur when a service line is partially paid or not paid at all. Visualcare surfaces these gaps during the reconciliation process so you don’t have to identify them manually.

Gap payment workflow

1. Upload the reconciliation file

   Open the submitted claim in Visualcare and upload the reconciliation file from Services Australia.

2. Review the Gap Analysis screen

   If gaps or non-payments are identified, a Gap Analysis screen appears. This lists each service line that has a gap, showing the claimed amount, the paid amount, and the difference.

   Export to CSV if you need a copy for your records or to share with your finance team. Click Confirm to proceed.

3. Note the updated claim status

   Claims with gap components update to Partially Paid status. This distinguishes them from fully paid claims in your claim list.

4. Generate invoices

   When you generate invoices for a partially paid claim, Visualcare creates up to three separate invoices:

   Invoice prefix	Invoice type	Filter by
   INVG	Government	Invoice Type: Government
   INV	Client Contribution	Invoice Type: Participant
   GAP	Gap payment	Invoice Type: Gap

   Use the Invoice Type filter to view each type separately.

5. Review statements

   Statements for the period show a breakdown of all three components: Government component, Client contribution, and Gap component.

6. Assign a payer to the gap invoice

   Click on the GAP invoice to select who will be billed for the gap amount.

   • Use the drop-down to select from contacts already in your accounting software
   • Or enter a payer using the free text field if the contact doesn’t exist yet

   Government invoices use the Agreement Payer or the Client Profile Payer by default. Client invoices use the client’s Accounting Code.

Export the Gap Analysis to CSV before confirming if you want a record of the original gap detail. Once you confirm, you won’t be able to access the pre-confirmation view again.

Running into issues?

See SAH claiming troubleshooting for common errors and fixes.

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Set up and manage Support at Home agreements