Payment statements for Home Care subsidy

Payment statements provide you with information about the Australian Government subsidy paid for care recipients receiving a Home Care Package in the specified month.

Introduction

We issue a printed payment statement with your new claim form, following a paper claim remittance and calculation. It is also available to view and print on the Aged Care Online Services system.

Payment statements include:

  • the month and year the payment statement was printed, shown at the top of each page
  • the date the payment statement was last revised and reprinted, shown at the bottom of each page
  • provider information on the front page
  • detailed information about care recipients to allow payment reconciliation
  • a payment summary of total subsidies and supplements paid for Home Care Packages, shown on the final page

Payment statements will not show if your service is over occupied. If we identify an over occupancy, we will contact you before your claim is finalised.

Statement features

Provider information

The provider information on the front page of the statement includes:  

  • provider ID
  • provider name
  • Australian Business Number (ABN)
  • service ID
  • service name, and
  • postal address

If you need to update your details, please refer to the Department of Health website.

Care recipient information

The image below shows the top section of the payment statement form.

A screen shot of a sample payment statement form

The service ID, service name and date of statement are listed on the top left hand side of the payment statement. The number of approved places for the service is on the right hand side.

Payment details for each care recipient of the service are listed in the body of the payment statement.

The basic admission details identify the care recipient and their date of entry and departure if applicable.

Adjustments

An adjustment is a payment or recovery amount applied to a service because of a reported event or change of circumstance that occurred in a previous claim period. This can include leave events, changes in the level of care or changes in means test information. The adjustment can be a one-off payment and/or recovery, or it can be applied over a number of claim months.

The Adjustment Claim Period specifies the month and year the adjustment was made. It is applied to the amount due to the care recipient to give a total credit amount. The total credit amount can be positive or negative.

The payment statement can show an Original Entitlement for the same period as the Adjustment Entitlement. The Original Entitlement will reverse the original amount paid, and the Adjustment Entitlement will apply the correct amount to be paid. The difference will be the adjusted amount, which will appear in the payment summary as adjustments for previous claim periods.

Other information

The payment statement will also include the following information:

  • details of the level of care and the payment type received, such as basic or supplements

  • the number of days if a care recipient left your service temporarily for respite care, hospital, social or transition care. The abbreviated leave codes used in the payment statement are:

    • RESP: respite care
    • HOSP: hospital care
    • TC: transition care
    • SOC: social care
  • the remaining entitlement available to the care recipient – allocations are reset on 1 July each year

  • details of any unpaid and reduced payment for leave the care recipient has taken

  • the care recipient’s total paid care days for the month and their remaining leave days

A subsidy is paid for leave taken. However, there is a cap on the amount paid for social leave and respite care. Care recipients are entitled to 28 cumulative days of social leave and 28 cumulative days of leave for residential respite care each financial year. The care recipient’s eligible daily rate is applied against the number of paid care days to give the total amount due to you. If the care recipient took reduced payment leave, the reduced rate, which is fixed at 25% of the basic subsidy rate, will be applied for the leave days.

Payment summary

The payment summary, located at the end of the statement, is a summary of all subsidies, supplements, adjustments and advances that contribute to the total amount paid to you for the specified month.

A screen shot of a sample payment summary

  • The total subsidy and supplements amount is a summary of the basic subsidy calculated
  • All applicable supplements will be listed
  • The subtotal applies any adjustments, refunds and reductions to the total subsidy and supplements amount
  • Any advances or outstanding balances from previous months are subtracted from the subtotal to obtain the overall due or heldover amount
  • The total amount to be remitted to the approved provider is the cumulative amount that we will pay you for the service in that month
  • The payment due will be paid into the nominated account within 2 to 5 business days of the claim being approved
  • A heldover amount occurs if the net effect of the calculations results in a negative amount. This amount becomes an outstanding balance that we will recover from you in the next claim cycle. For example, if you received an advance payment of $10,000 for January 2014 but the calculated claim entitlement was actually $9,000, you will have a heldover amount of $1,000

Page last updated: 13 July 2016

This information was printed Sunday 2 October 2016 from humanservices.gov.au/health-professionals/subjects/payment-statements-home-care-subsidy 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.