Choosing an online claiming channel for aged care

We can help you choose the online claiming channel that best suits your business model.

Integrated software

Integrated software is currently only available to Residential Care providers, but will become available to Home Care providers in the future.

Business to Government (B2G) integrated software

Residential Care providers can use B2G integrated software. It allows you to interact with us using integrated software developed by a software vendor.

This channel submits one event at a time to us for processing. An 'event' is a business activity that has occurred in an aged care service for example, a care recipient entering care.

Software vendors integrate the information and tools provided by us into their own solution for signing and transmitting the electronic data. Providers using the B2G channel need to use software that has been approved by us.

File Upload integrated software and website

Residential Care providers can create a file using integrated software developed by your software vendor. The file is then transmitted electronically by authorised staff to us through Aged Care Online Claiming. Each file transmitted by the provider may contain up to 50 events.

Residential Care providers using the File Upload channel need to use software that has been approved by us. You need to have access to the Aged Care Online Claiming website to transmit electronic data and check the processing status of the data.

Read more about Getting started with integrated software.

Web forms

Residential Care and Home Care providers can enter selected aged care information directly into a web form and submit this information to us electronically. Services using online claiming do not need to have specially developed software.

When you logon to online claiming, you can:

  • check the processing status of transmitted web forms
  • view current or historical claim details
  • view or download current and historical payment statements
  • search and view care recipient information through the care recipient profile
  • lodge, update and delete web forms, and
  • view electronic Aged Care Client Record assessments

The following web forms are available for Residential Care and Home Care providers:

Residential Care

  • Aged Care Funding Instrument
  • Residential permanent entry
  • Residential respite entry
  • Residential departure
  • Residential extra service
  • Residential leave
  • Residential enteral feeding end date
  • Residential oxygen end date
  • Residential liability

Home Care

  • Home Care entry
  • Home Care departure
  • Home Care hours of service
  • Home Care leave
  • Home Care location
  • Home Care bulk hours of service

Set up costs

Online claiming using integrated software

The costs involved in setting up the integrated software channel will depend on the:

  • software products needed
  • size of your service
  • system infrastructure you have in place
  • software you use
  • staff training required, and
  • ongoing licence costs

Online claiming using web forms

If you have access to the internet, then using online claiming via web forms to view and download payment statements and transmit web forms carries no additional charge. There may be some costs related to training your staff.

Security measures and the need for software

Online claiming using B2G-integrated software

Public Key Infrastructure (PKI) technology is used to secure and authenticate data communication between aged care providers and us.

The B2G channel requires site certificates that use PKI technology so that we can identify the electronic data transmitted through this channel by your service. You need to install specially developed software.

Online claiming using File Upload-integrated software and website

Security is through the Aged Care Online Claiming website, which uses authenticated access control and passwords. You need to install specially developed software.

Online claiming using web forms-website

Users log on to online claiming with a secure, unique user ID and password.

There is no need for specially developed software.

We are currently introducing a new online claiming system for aged care providers, known as Aged Care Online Services.

All providers will continue to log on to online claiming via the online claiming log on page. You can log on using the same user ID and password.

If you are registered for Aged Care Online Claiming as a Home Care user only, you will automatically be redirected to Aged Care Online Services. If you are registered as a Home Care user, and can only view the payment statement, you will not be redirected to Aged Care Online Services. You will continue to use Aged Care Online Claiming.

Site certificates

The B2G channel requires the use of site certificates to enable a provider (or representative administration locations) to transmit events. Site certificates are required to identify the message sender (or site) and are provided as software certificates on a CD that may be loaded onto a system.

When registering new providers that have chosen to transmit using integrated software, a service officer will make sure that the site certificates are issued by our IT Security. We will complete an application on your behalf using the information provided as part of the online claiming registration process. Our IT Security will provide you with the site certificate and pass phrase.

These certificates can be used to support a variety of different B2G operational models.

Claiming via the B2G channel is currently available to Residential Care providers only.

Individual certificates

Individual PKI certificates are issued by our IT Security, and act as an electronic signature for an individual.

Where an individual PKI certificate is required for Aged Care Online Claiming, this will be provided on a shell token.

When registering users for Aged Care Online Claiming, our staff will make sure that individual certificates are issued by our IT Security where required. We will complete an application on your behalf using the information provided as part of the online claiming registration process. Our IT Security will provide you with a shell token containing your personal certificate, a start up pack and a 'pass phrase' that will be mailed separately.

For more information about individual or site certificates, contact us.

Claiming via the B2G channel is currently available to Residential Care providers only.

Software currently used in your service

Online claiming using integrated software

This channel is currently only available to Residential Care providers.

Your service set up requirements and the aged care management software you already have installed may determine what your options are. Speak to your current software vendor to determine if you can use the B2G or File Upload channel to transmit electronic data to us.

Online claiming using web forms

Online claiming does not require special software.

Getting started with integrated software

This channel is currently only available to Residential Care providers.

Step 1: check your IT infrastructure

Consider your network and IT infrastructure before participating in Aged Care Online Claiming. Your software vendor will be able to help you with this process.

Step 2: select a software vendor

Software vendors integrate the information and tools provided by us into their own software solution for signing and transmitting electronic messages. We will issue a notice of integration to vendors when they have demonstrated that their product satisfies the required criteria and standards.

See the list of software vendors who have been issued with a notice of integration. You can choose a software vendor from this list and arrange for them to install their software on your computer. If you currently have software in place with a software vendor who is not on this list, you need to ask them if they have an approved, Aged Care Online Claiming enabled product in place. If they do not, you need to consider either changing to a software vendor who is on the list, or use the Web Form channel.

Work with your software vendor to arrange installation and testing of your new or upgraded software. Your software vendor will also provide you with a Minor Customer ID, which you will need when completing the registration form. This will assist us in managing the transmitted data.

Any staff training that may be required to use the new or upgraded software will need to be arranged with your software vendor, who may also be able to assist you in the data synchronisation process.

Step 3: check your business environment

You must check your business environment to determine any changes needed to implement Aged Care Online Claiming, and decide who you will authorise in your organisation to be responsible for transmitting the data.

Other considerations depend on your current structure and operational procedures, and may include:

  • implementing effective storage and archiving processes for the electronic files that are sent to us for processing
  • ensuring appropriate logging and audit trails
  • training your staff

Step 4: register for online claiming

Approved providers using integrated software will need to register for online claiming by completing the Register or amend for Aged Care Online Claiming using File Upload or Business to Business form. This form can be used to authorise staff to sign and view data when using online claiming.

We will authorise access to the Aged Care Online Claiming website by providing staff with a user ID and password. Depending on whether the service requires PKI technology, the registration form will also initiate a request to us to supply the appropriate certificates, where required.

Step 5: synchronise and cleanse your data

If you choose integrated software to claim online, you should synchronise and cleanse your data with us before transmitting, to minimise the potential for errors and delays.

Once you are ready to start claiming online, you will need to provide us with an electronic file of your occupancy records. Our processing staff will cross check your records against the resident's details in our payment systems.

We will provide you with a report identifying any discrepancies that will need to be corrected on your database before you start using online claiming.

Read more about Data cleansing and synchronisation or call us.

Step 6: enable integrated software

Arrange for your software vendor to install the software.

Step 7: log onto the Aged Care Online Claiming website

When the registration process is complete, authorised staff will be allocated a user ID and password that will allow access to the Aged Care Online Claiming website.

Contact us

Contact us about online claiming for aged care.

Page last updated: 14 October 2016

This information was printed Sunday 4 December 2016 from humanservices.gov.au/health-professionals/enablers/choosing-online-claiming-channel-aged-care It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.