# Claim Management

The Claim Management component is a bit of a '*jack of all trades*' when it comes to claiming and can be used to support a few important scenarios, such as:

* If you need to **reclaim** a failed `Payment Request` (API and BPR)
* &#x20;If you wish to **review** your `Invoices` **prior** to claiming - you can use the Claim Management component to generate `Payment Requests` and submit these to PRODA via either the API or the BPR File process

## Reclaiming

Whilst we would love to think otherwise, not all claiming attempts are successful and result in the funds being claimed and paid to your bank account.  A `Payment Request` can be `Rejected` by the NDIS, i.e. service date is outside the active `Service Booking`, or you may experience a `Failed` `Payment Request` meaning that the claim has not been successfully submitted to the NDIS for processing, i.e. a technical issue with the API.

Examples of a `Payment Request` in `Rejected` and `Failed` `Status` can be seen below:

<figure><img src="https://558904096-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FKdn9R0jFmixyPeVowFpF%2Fuploads%2FK9tXgZw5a3fJ3futwlN3%2Fimage.png?alt=media&#x26;token=e506f0c2-93cb-4bf8-a19c-4283c5f9a6aa" alt=""><figcaption><p>Example of a Rejected Payment Request</p></figcaption></figure>

<figure><img src="https://558904096-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FKdn9R0jFmixyPeVowFpF%2Fuploads%2FRy1Cl2t5Twxt7vC8xi0E%2Fimage.png?alt=media&#x26;token=bc10a921-5e2b-4354-8344-bf6dc789f415" alt=""><figcaption><p>Example of a Filed Payment Request</p></figcaption></figure>

Now, for some of the `Rejected` or `Failed` `Payment Request` records, this is the end of the line and no further action can be taken as the errors cannot be addressed and the claim cannot be processed.

For other unsuccessful claims, however, many of these can be reviewed by your team and the error(s) rectified in order to try the `Payment Request` again, or **reclaim** the funds.  This is where the Claim Management component comes into the picture.

Once you have addressed the cause of the initial `Reject Reason` or `Error` provided on the `Payment Request`, the record is ready to be **reclaimed**.  In order to this, simply navigate up to the `Invoice` the `Payment Request` is associated with (this is through the `Invoice Line Item`).  Once you are at the `Invoice` level, click the **Claim** Quick Action to launch the current `Invoice` in the Claim Management component.

<figure><img src="https://558904096-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FKdn9R0jFmixyPeVowFpF%2Fuploads%2Fc6VUuMqe7HG6AfWkT7D4%2Fimage.png?alt=media&#x26;token=5f2a3f72-cec4-418d-8766-2c747ec62b6e" alt=""><figcaption><p>The Claim Quick Action on the Invoice record</p></figcaption></figure>

From the Claim Management component, the key `Invoice` information is displayed at the top, whilst directly underneath, all **applicable** `Invoice Line Item` records are listed in a table-style format. &#x20;

{% hint style="info" %}
The logic as to what defines a valid or **applicable** `Invoice Line Item` is defined in the Rules and Validation section below.
{% endhint %}

<figure><img src="https://558904096-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FKdn9R0jFmixyPeVowFpF%2Fuploads%2FfL6F1bVFC3Ap50fYvn9B%2Fimage.png?alt=media&#x26;token=17c06339-b8a7-4b1b-96a9-a523aa75ee5e" alt=""><figcaption><p>The selected Invoice in the Claim Management component</p></figcaption></figure>

Some base information is displayed for each `Invoice Line Item`, such as the `Support Category` and `Support Item`, however the most relevant for this **reclaim** scenario are:

* `Claimed Amount`
* `Available Claim Amount`
  * Represents the `Claim Balance` or the **maximum** value remaining that can be claimed
* `Claim Amount`
  * Use this to specify the amount you would like to claim in the attempt&#x20;
  * Amount **defaults** to the `Available Claim Balance` but supports a **lower** value if desired

From here, confirm all the details are correct, i.e. ensure the `Claim Amount` reflects the appropriate value, check the confirm box and click **Claim**.  What happens next changes based on your `Claim Method` defined under Claim Settings --> Maica Settings.

### Reclaiming when Claim Method = API

If your claiming is managed via the API (`Claim Method` = `API`), then there is nothing left for you to do!  The new `Payment Request` record(s) is created and submitted to PRODA for claiming **immediately** and the `Invoice` `Claim Behaviour` is set to `Claim Attempted`.

### Reclaiming when Claim Method = BPR File

In this scenario, a **new** `Payment Request` record is generated (for your Claim Amount), however, it is **not submitted** for claiming automatically.  The `Payment Request` is created with a **BLANK** `Status`, making it available to be picked up via the standard [BPR File generation process](https://knowledge.maica.me/welcome-to-maica/general-information/maica-settings/claim-management#bulk-payment-request-bpr-file-generation).

Once the **BPR File is generated** (with the the newly created `Payment Request` record(s) included) the `Invoice` `Claim Behaviour` is set to `Claim Attempted`.

<figure><img src="https://558904096-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FKdn9R0jFmixyPeVowFpF%2Fuploads%2FANUeyTTlh6OJNxZs5tlT%2Fimage.png?alt=media&#x26;token=52e6abf8-861d-44d3-b275-57b76bdde949" alt=""><figcaption><p>Success message when reclaiming via the BPR File</p></figcaption></figure>

### Invoice Review and Claim

If your claiming process involves a **review** or **validation** step, this would mean that your `Invoice` records are created in Salesforce with the `Claim Behaviour` set to either `Under Review` OR `Do Not Claim` (we would recommend `Under Review`).

For `Invoice` records in this state, **no** `Payment Request` record is created and therefore no claim is submitted (which is exactly what you would want so you could review and validate)!

Once you have reviewed the `Invoice` and are ready to claim, simply follow the steps described in this article and pay attention to the [Reclaiming when Claim Method = BPR File](#reclaiming-when-claim-method-bpr-file) section above as it describes how the `Invoice` and `Payment Request` the records are handled.

### Rules and Validation

The Claim Management component, like many in Maica, enforces some base rules and logic that it is important for you to be aware of prior to using it. &#x20;

Specifically, any `Invoice Line Item` record with an associated `Payment Request` record with one of the `Status` values below cannot be reclaimed.  Maica considers `Payment Request` records with these `Status` values to be part of an **active claim cycle**, either API or BPR File, and we do not want the Claim Management component to generate a duplicate `Payment Request` erroneously.

* `BLANK`
* `Awaiting Approval`
* `Pending Payment`

{% hint style="info" %}
Should you wish to include an `Invoice` record with such an existing `Payment Request`, you need to first **cancel** the `Payment Request` via the Cancel Quick Action on the `Payment Request` itself.
{% endhint %}
