Invoice Overview

Learn about Invoices within Maica

What is an Invoice?

An Invoice in Maica represents the financial component following an instance of Service Delivery. It is comprised of Invoice Line Items, one for each delivered Service across a billing period which dictates how long an Invoice is open for before being finalised. It also houses Payment Request records.

Invoice Key Terms and Components

Whilst working with Invoice(s) and any associated Invoice Actions, you will come across a number of key terms and related components. The table below describes each of those in further detail:

Key Term	Type	Description
Invoice Line Item	Related Object	An Invoice Line Item is a specific entry on an Invoice that details a particular service provided, including its Quantity, Amount, Support Category, etc.
Payment	Related Object	A Payment represents the financial transaction used to process the Invoice Amount.
Invoice History	Related Object	Invoice History is a record of all actions and changes related to any specific invoice, including Change Date & Times, etc.
Claim Behaviour	Field	A Claim Behaviour in Maica determines how Payment Requests are managed, created, and submitted to the NDIS for processing based on your selected Settings. It allows you to control the way claims are handled based on your organisation's workflow requirements.
Funding Type	Field	Funding Type refers to the specific method by which Care and Support Services are financed, determining how funds are managed and payments are processed for the services received.

Please note, setting the Claim Behaviour on an individual Invoice will override the Global Setting for Claim Behaviour within your Maica instance. If no Claim Behaviour is set on the Invoice level, the Global Setting will be applied. To learn more, click here.

Invoice Statuses

Whilst working with Invoice(s), you will notice a Status Bar at the top of the page, as shown below. The default stage for an Invoice is Entered.

These Statuses outline the stage of the lifecycle any particular Invoice will be in at any particular time. Using Maica, the Status is adjusted dynamically depending on a range of factors and logic that are described below, and explained in further detail here.

The Partially Paid and Fully Paid status logic can differ based on whether the Funding Structure = Agency Managed or not. The logic that sets the described statues from both scenarios is explained below.

Status	Description	Logic
Entered	The invoice has been created and recorded in the system but no payment actions have been taken yet.
Cancelled	The invoice has been manually cancelled and will not be processed for payment.	Cancelled = TRUE

When the Funding Structure equals Agency Managed, the Partially Paid status is set by the following logic:

Status	Description	Logic
Partially Paid	The Amount from the associated Invoice Line Item record(s) has been partially claimed. There is a Claim Balance remaining.	Total Line Items > 0 AND Total Claimed Amount < Total Amount AND Total Claimed Amount > 0 AND Claim Balance Formula > Paid Tolerance

When the Funding Structure does not equal Agency Managed, the Partially Paid status is set by the following logic:

Status	Description	Logic
Partially Paid	A portion of the invoice amount has been paid, but there is still an outstanding balance. The Payment Amount less than Total Amount.	Total Payment Amount > 0 AND Total Payment Amount < Total Amount

When the Funding Structure equals Agency Managed, the Fully Paid status is set by the following logic:

For the Fully Paid status, please refer to the following Condition Logic:

Condition Logic

(1 AND 2 AND (3 OR 4))

This logic checks if conditions 1 and 2 are both true, and then it evaluates whether either condition 3 or condition 4 is true. For the overall condition to be true, both 1 and 2 must be true, and in addition, either 3 or 4 must also be true.

Status	Description	Logic
Fully Paid	The Amount from the associated Invoice Line Item record(s) has been fully claimed. There is zero Claim Balance remaining.	Funding Structure = Agency Managed Total Line Items > 0 Total Claimed Amount >= Total Amount Claim Balance Formula <= Paid Tolerance

When the Funding Structure does not equal Agency Managed, the Fully Paid status is set by the following logic:

Status	Description	Logic
Fully Paid	The Amount from the associated Invoice Line Item record(s) has been fully claimed. There is zero Claim Balance remaining.	Total Line Items > 0 AND Total Payment Amount >= Total Amount

Claim Behaviour Options

A Claim Behaviour in Maica determines how Payment Requests are managed, created, and submitted to the NDIS for processing. It allows you to control the way claims are handled based on your organisation's workflow requirements.

Please note, the below descriptions talk to the available Claim Behaviour options at an Invoice Entry Level, to learn about setting a Claim Behaviour on a Global level, please refer to the Claim Management Settings.

Below is a explanation of the available Claim Behaviour options and how they impact the claiming process.

Claim Behaviour	Description	Payment Request Created?
Use Claim Settings	Applies the default Claim Settings configured by your organisation. These settings define how and when claims are processed for all Invoices unless overridden at the point of entry.	Yes ✅
Claim Immediately	Automatically processes the claim with PRODA as soon as the Invoice is saved. A Payment Request is generated for each Invoice Line Item, submitted to PRODA, and updated with the result (e.g., Success/Fail) in near real-time.	Yes ✅
Claim via BPR File	Prepares Payment Requests for inclusion in a Bulk Payment Request (BPR) File. These records are saved with a Blank status and can be manually uploaded to the myplace provider portal for processing.	Yes ✅
Do Not Claim	Creates the Invoice in Maica but does not generate a Payment Request. Useful for historical records or for Invoices meant to be sent to Plan Managers or Participants outside of the NDIS claiming process.	No ❌

When the Do Not Claim option is selected, the Invoice will not be included in the BPR File or submitted via the API, even if related Payment Request records exist. The Claim Behaviour can be updated to Claim Immediately for API-based processing, or manually uploaded for BPR File processing