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Caresquare QA Warnings and Claim Flags

In Caresquare, warnings can appear at two levels: the invoice level and the individual line item (claim) level.

  • Invoice-level warnings apply to the entire invoice. These are general warnings that may not relate to any specific line item.

  • Claim-level warnings apply only to the specific line item they are attached to. They reflect issues found within that individual claim, independent of any other line items on the invoice.

NOTE :When a claim-level error is detected during invoice ingestion, it will trigger the invoice-level warning “Claim errors found.”

We've also broken down QA warnings, their associated icon and what this means below:

Warning

Icon

Meaning

Overlapping Lines: XX invoice(s) with XX overlapping line item(s)

The system has identified existing invoices where services were delivered on the same day for the same participant and provider.

No Budget Data: No budget information available for this participant

The system was unable to retrieve relevant budget data for this invoice.

Budget Issues: XX item(s) with insufficient budget / XX unmatched item(s)

There are either insufficient funds available, or the system cannot match one or more items to an approved funding category.

Requires Approval: This invoice requires approval (or missing participant/provider)

Approval is needed before processing. This may also occur if participant or provider details are missing.

Approval Requested: This invoice is pending approval

An approval request has been submitted and is awaiting review.

Invoice is over 90 days old: Invoice is XX days old, please ensure it's still valid for claiming

Please confirm the invoice is still valid and eligible for claiming.

Check funding period: One or more service dates are from a prior funding period

Services may belong to a previous funding period and should be reviewed.

SIL/STA: Supporting documentation may be required

Additional documentation may be needed for Supported Independent Living (SIL) or Short-Term Accommodation (STA) claims.

Possible duplicate: A similar invoice has been detected in the system

The system has identified an existing invoice with the same invoice number and provider. Partial matches (e.g. similar-looking invoice numbers or prefixes) may also trigger this warning.

Provider limit exceeded: This invoice exceeds the provider payment limit

The total claimed amount exceeds allowable limits based on existing records.

Flagged provider: This provider has been flagged

The provider has known issues or notes on record (details shown where available).

Claim errors found: One or more line items have claim rule violations

Some items do not comply with claiming rules and require review.

Custom rule violated: This invoice violates a custom rule

A rule set up for this participant has been triggered.

Provider compliance decision: This provider has an NDIS Commission compliance decision on record

There are compliance findings associated with this provider.

Flagged participant: This participant has been flagged

A flag has been applied at the organisation level. Check the participant profile for details.

Reimbursement: This invoice has been flagged as a reimbursement

The claim represents a reimbursement rather than a standard provider invoice.

Budget allocation violated: XX allocation rule(s) violated (categories listed)

The invoice does not align with predefined budget allocation rules.

Spending limit exceeded: XX spending limit(s) exceeded (categories listed)

The claim exceeds defined spending limits for one or more categories.

For additional flags and breakdown of where to find these and their category level, please see below:


Warning/s Flags

Category

Where to Find

Check bank account details

Invoice-level warning

Invoice QA Warning

Check dates

Invoice-level warning

Invoice QA Warning

Check early childhood

Invoice-level warning

Invoice QA Warning

Check funding period

Invoice-level warning

Invoice QA Warning

Check GST

Invoice-level warning

Invoice QA Warning

Check item code

Invoice-level warning

Invoice QA Warning

Check Provider

Invoice-level warning

Invoice QA Warning

Check SIL/STA

Invoice-level warning

Invoice QA Warning

Check total

Invoice-level warning

Invoice QA Warning

Claim errors found

Invoice-level warning

Invoice QA Warning

Custom rule violation

Invoice-level warning

Invoice QA Warning

First time provider for participant

Invoice-level warning

Invoice QA Warning

Flagged participant

Invoice-level warning

Invoice QA Warning

Flagged provider

Invoice-level warning

Invoice QA Warning

Missing invoice number

Invoice-level warning

Invoice QA Warning

Missing participant

Invoice-level warning

Invoice QA Warning

Missing Xero contact

Invoice-level warning

Invoice QA Warning

Multiple participants found

Invoice-level warning

Invoice QA Warning

Multiple providers found

Invoice-level warning

Invoice QA Warning

Possible duplicate

Invoice-level warning

Invoice QA Warning

Provider limit exceeded

Invoice-level warning

Invoice QA Warning

Warning/s Flags

Category

Where to Find

Approval Requested This invoice is pending approval.

Invoice-level warning

Invoice Banner (when you open the Invoice)

Check funding period One or more service dates are from a prior funding period

Invoice-level warning

Invoice Banner (when you open the Invoice)

Hold Reason

Invoice-level warning

Invoice Banner (when you open the Invoice)

No Budget

Invoice-level warning

Invoice Banner (when you open the Invoice)

Participant is flagged with reason: [flag_reason]

Invoice-level warning

Invoice Banner (when you open the Invoice)

POSSIBLE DUPLICATE A similar invoice has been detected in the system

Invoice-level warning

Invoice Banner (when you open the Invoice)

Provider is on [participant_name]'s approval exclusion list.

Invoice-level warning

Invoice Banner (when you open the Invoice)

Rejection Reason [rejection_reason]

Invoice-level warning

Invoice Banner (when you open the Invoice)

Requires Approval This invoice requires approval

Invoice-level warning

Invoice Banner (when you open the Invoice)

Rule Violation(s) [message]

Invoice-level warning

Invoice Banner (when you open the Invoice)

SIL/STA Supporting documentation may be required.

Invoice-level warning

Invoice Banner (when you open the Invoice)

You flagged this provider for (reason)

Invoice-level warning

Invoice Banner (when you open the Invoice)

Warning/s Flags

Category

Where to Find

ALLOCATION rule exceeded - There is no remaining budget for this provider

Individual line item (claim) level warning

Claims Flags

Cannot claim line item that is less than 0

Individual line item (claim) level warning

Claims Flags

Claim has already been attempted for line item

Individual line item (claim) level warning

Claims Flags

Insufficient budget for line item

Individual line item (claim) level warning

Claims Flags

Invalid ABN - checksum validation failed

Individual line item (claim) level warning

Claims Flags

Invalid service item number: {service_item_number}

Individual line item (claim) level warning

Claims Flags

Invalid unit price or quantity for line item

Individual line item (claim) level warning

Claims Flags

LIMIT rule exceeded between participant and provider

Individual line item (claim) level warning

Claims Flags

Line item does not fall within budget dates

Individual line item (claim) level warning

Claims Flags

Line item does not fall within budget dates

Individual line item (claim) level warning

Claims Flags

Line item does not fall within plan dates

Individual line item (claim) level warning

Claims Flags

Line item does not fall within service booking dates

Individual line item (claim) level warning

Claims Flags

Line item exceeds service booking remaining amount

Individual line item (claim) level warning

Claims Flags

Line item is missing GST code

Individual line item (claim) level warning

Claims Flags

Missing participant number for invoice

Individual line item (claim) level warning

Claims Flags

No budget found for participant

Individual line item (claim) level warning

Claims Flags

No item catalogue match found for service item with service region {service_region_id}

Individual line item (claim) level warning

Claims Flags

No service booking found for participant

Individual line item (claim) level warning

Claims Flags

No support category match found for service item

Individual line item (claim) level warning

Claims Flags

Service date from is greater than service date to for line

Individual line item (claim) level warning

Claims Flags

Service date from is in the future for line item

Individual line item (claim) level warning

Claims Flags

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