Funders
Workers compensation payments by scheme
The claiming gateway settles four channels: icare, WorkSafe Victoria, Comcare and QBE. It pays one aggregated amount per settlement period, so a single credit can hold three of them and a card payment. Its WorkSafe Victoria and QBE channels take general practice, physiotherapy and pharmacy claims today. WorkCover Queensland and any scheme invoiced by email pay you themselves. Post each through its own clearing account.
Key facts
- Who is on the bank line
- The claiming gateway for icare, WorkSafe Victoria, Comcare and QBE, paid out of its own settlement run rather than by the scheme1
- What the gateway does not settle
- Medicare, DVA, ECLIPSE, WorkCover QLD and HealthPoint sit outside its settlement, so those funders pay the practice themselves1
- Approval cut off
- 5pm Australian eastern time for these insurers, and a claim approved after it falls into the following business day's settlement period2
- When funds land
- The business day after the scheme approves the invoice inside the gateway2
- How claims are grouped
- Claims from different insurers, and card payments issued by the gateway, are included in the same aggregated settlement2
- What the remittance report covers
- Every payment to the provider for that settlement period, which can include other funding sources such as icare, Comcare and payment cards2
- How fast the gateway answers on icare and Comcare
- About 75 percent of claims are adjudicated in real time with a response inside 30 seconds, and the rest run from hours to typically two business days4
- How fast it answers on WorkSafe Victoria and QBE
- About 60 percent of claims are adjudicated in real time with a response inside 30 seconds, and the rest run from hours to typically two business days2
- What one rejected item does on icare and Comcare
- One rejected service item marks the whole invoice as declined, so none of it settles3
- What one rejected item does on WorkSafe Victoria and QBE
- Each service item carries its own status, and an invoice with at least one approved item is marked approved, so part of it can settle2
- Revenue account in the allied health template
- 407 Clinical services, WorkCover and workers compensation, at the GST free income rate10
- Clearing accounts in the allied health template
- 105 Tyro Health clearing for the gateway settlement, 108 WorkCover clearing for the Queensland scheme, and 109 Insurer clearing for an insurer paying the practice itself10
Which scheme pays you, and which one only approves the claim
Workers compensation is not one funder. It is a set of statutory schemes, state by state and one federal, each with its own claim rules. The question that decides your reconciliation is not which scheme treated the injured worker. It is who puts the money in your account, and for several of these schemes the answer is a claiming gateway rather than the scheme itself.
The gateway's own settlement article draws the line. It settles its online card payments, nib Direct, Comcare, icare, QBE and WorkSafe Victoria, and it states that it does not manage settlement for any other insurers, naming Medicare, DVA, ECLIPSE, WorkCover QLD and HealthPoint. So an icare invoice lodged there becomes gateway money. A WorkCover Queensland invoice lodged in the same screen becomes scheme money, on a different day, into a different account.
One credit, several schemes, one remittance report
Where the gateway pays, it pays once per settlement period. Claims from different insurers, and card payments it issued in the same period, are grouped into a single aggregated settlement. A practice whose icare claim and Comcare claim are approved before the same 5pm cut off, with a card payment taken that day, can see all three inside one credit.
Remittance reports will include all payments to a provider for the given settlement period which can include payments for other funding sources such as icare, Comcare and payment cards.2
That sentence is the whole reconciliation problem in one line, and it is published on a developer portal written for integrators rather than on any accounting page. It means the split you need is in the remittance report, not in the bank feed. Trying to read the funder off the bank narration is a dead end, because the narration describes the gateway and the schemes are one level down.
The clock starts at approval, not at lodgement
Lodging an invoice does not start a payment timer. Approval does. Each of these schemes runs a 5pm Australian eastern time end of day, and a claim approved after it is carried into the following business day's settlement period. Approval itself can be immediate or can take a couple of days, which is where the variation in a practice's ageing report comes from.
The gateway publishes a figure per scheme: roughly 75 percent of icare and Comcare claims adjudicated in real time inside 30 seconds, roughly 60 percent of WorkSafe Victoria and QBE claims, the rest from hours to typically two business days. The schemes publish no equivalent, so read these as the gateway's distribution rather than a service standard.
A declined invoice is not a short payment
How a rejection lands depends on the scheme. icare and Comcare reject at the invoice level: one rejected service item marks the whole invoice as declined, so nothing arrives to reverse. WorkSafe Victoria and QBE give each item its own status, and an invoice with at least one approved item is marked approved, so part of it settles.
Compare that with a funder that pays at a price limit and leaves a shortfall, or one that claws money back inside a later remittance. A rejected item here stays unpaid until it is corrected and resubmitted, so writing the difference off is the wrong move. Nobody has agreed to pay it yet.
- Outstanding means the scheme is still reviewing the claim, and no money is owed on the settlement run yet.
- Approved means the claim is in the next settlement, and the receivable is real.
- Declined means the invoice will not be paid as lodged. On icare and Comcare the whole invoice carries that status even where one item caused it.
- Cancelled means the provider withdrew the claim before settlement.
- Completed means the approved claim has been paid to the provider and the credit should be in the bank.
The channel changes the payer and the fee
The same scheme can be claimed through more than one digital channel, and the channel decides who pays you and whether it takes your profession. HICAPS Digital publishes its participating government schemes and its pricing per scheme, and Comcare is not on that list. The gateway's icare and Comcare channels take the wide allied health list; its WorkSafe Victoria and QBE channels take general practitioners, physiotherapists and pharmacies today, so other modalities claim WorkSafe Victoria through HICAPS Digital or by email.
| Scheme | Through the claiming gateway | Through HICAPS Digital |
|---|---|---|
| icare NSW | Settled by the gateway the business day after approval | Listed as a government scheme claimed at no claiming fee |
| WorkSafe Victoria | Settled the business day after approval, for general practice, physiotherapy and pharmacy claims | Listed as a government scheme claimed at no claiming fee |
| Comcare | Settled by the gateway the business day after approval | Not on the published scheme list |
| WorkCover Queensland | Lodged but not settled, so the scheme pays the practice itself | Listed as a government scheme claimed at no claiming fee |
| Transport accident scheme | Not on the gateway's settled list | Charged at 1.45 percent of the approved claim |
No claiming fee is not the same thing as no cost, and it says nothing about who is on the bank line. Those are two questions: what the channel charges, and whose money arrives. The second is the one your chart of accounts has to answer.
Treatment is GST free, the report the scheme asks for is not
Section 38-60 covers a supply to an insurer, a statutory compensation scheme operator, a compulsory third party scheme operator or an Australian Government agency. Where the service is GST free to the patient it stays GST free when the provider contracts with one of them, so the state schemes here sit on the scheme operator limb and a commercial insurer such as QBE on the insurer limb. The allied health canonical template posts both to account 407 at the GST free income rate.
A report or an assessment the scheme asks for is a different supply. The ATO treats a report as GST free only where a Medicare benefit is payable for it or it is an ordinary and natural part of the GST free service, and the worked example it gives, a progress report a compensation insurer asks for, meets neither test. The template splits that out to account 420, Reports, assessments and medico-legal, at the GST on income rate. One claim can produce two revenue lines with two tax treatments, which is why the map holds a row per service category rather than a row per funder.
- Treatment sessions billed to the claim sit on the workers compensation revenue account at the GST free rate.
- A report or assessment the scheme requests, where it is not an ordinary and natural part of the treatment, sits on the reports account and is taxable.
- Section 38-60 lets a scheme and a provider agree not to treat the supplies as GST free, so the template asks a practice to confirm none of its schemes has done that.
- The clearing leg is a movement of money that has already been recognised as revenue, so every canonical template posts it as BAS excluded.
A clearing account per payer, not one workers compensation account
Grouping every compensation scheme into one Xero account looks tidy and then hides which scheme owes the money. The canonical template splits on the payer instead. Account 105, Tyro Health clearing, holds what the gateway has approved but not yet banked. Account 108, WorkCover clearing, holds the Queensland scheme, which pays on its own run. Account 109, Insurer clearing, holds an insurer paying the practice itself.
- Receipt each approved claim into the clearing account for its payer, on the date the scheme approved it rather than the date the bank line shows up.
- Match the credit as a transfer out of that account, using the remittance report for the settlement period as the reference on both sides.
- Split the remittance by scheme before you post, because the revenue lines underneath the credit can sit on more than one account and more than one tax rate.
- Leave a declined invoice outstanding. It is not a shortfall and it is not a write off until the scheme has been asked again.
- Read the balance as approved claims the bank has not delivered yet, and chase an old one in the gateway rather than in Xero.
What stalls a claim before any of this matters
Most workers compensation invoices that do not turn into money were stopped upstream of the accounts team. Treatment beyond the scheme's initial allowance needs approval, and the claiming screen helps on some schemes only. The gateway's icare and Comcare integrations carry no patient quote for a service still to be rendered, so that conversation happens by phone or in the scheme's portal. Its WorkSafe Victoria and QBE integrations do quote, checking the claim number and returning the expected benefit.
That is the same pattern the canonical templates encode, arrived at by hand. The practical version for these schemes: check the claim status before you chase the money, check the approval before you chase the status, and check that a report has not been coded as treatment before you check anything else.
What Ledger Map does with it
Ledger Map holds one standing map for the practice, approved once. A workers compensation line resolves to its account and tax rate through that map, the settlement is posted as one balanced document set against the clearing account for its payer with the claims underneath it, and one exact match is left in the bank feed for the practice to accept.
Where a line cannot be resolved, it becomes a question with the options laid out rather than a silent posting. Nothing on this page is a treatment Ledger Map picked: the accounts and rates come from the canonical template the practice starts from, and the practice approves the map before an invoice syncs. See how it works for the approval step, Tyro Health for the settlement rail itself, or the funder index for the other rails a practice reconciles beside this one.
Questions
Who actually pays me for an icare or WorkSafe Victoria claim?
The claiming gateway does. Its settlement article lists Comcare, icare, QBE and WorkSafe Victoria among the funders it settles itself, so the money reaches you from the gateway rather than from the scheme. That is why those claims belong in the gateway's clearing account rather than in one named for the insurer.
Why does one deposit cover more than one workers compensation scheme?
Because claims from different insurers, and card payments issued by the gateway, are included in the same aggregated settlement. The remittance report for that period lists every payment behind the credit, including other funding sources, so the split lives in the report rather than in the bank feed.
Is workers compensation income GST free?
Treatment is GST free under s38-60 where the same service billed to the worker would be, and the canonical allied health template posts it to the workers compensation revenue account at that rate. A report the scheme asks for is GST free only where a Medicare benefit is payable for it or it is a natural part of the treatment, so it usually sits on the reports account and is taxable.
What happens when the scheme rejects one item on my invoice?
It depends on the scheme. On icare and Comcare the whole invoice is marked as declined, so it stays an unpaid invoice rather than arriving as a negative line inside a later payment. On WorkSafe Victoria and QBE each item carries its own status and an invoice with at least one approved item is approved, so the rest can settle. Either way, correct the item and resubmit rather than writing the difference off against revenue.
Does WorkCover Queensland arrive in the same deposit?
No. The gateway states it does not manage settlement for WorkCover QLD, so that scheme pays you by its own transfer once the claim owner authorises the invoice. Expect it as a separate bank line, on its own day, against its own account.
Read next
Sources
Open questions
- Whether a practice sees one credit for the whole settlement period or one credit per scheme is not settled by the published wording, and can differ by bank account setup. The settlement article describes a single settlement amount and the developer portal describes one aggregate payment across insurers. The canonical template's own note on the Tyro Health rail reads it as one settlement per funder per day, so the corpus and the gateway's pages are not saying quite the same thing, and neither states the bank level outcome.
- Comcare is on the gateway's settled list but not on the other digital claiming channel's published scheme list, so a practice on that channel may have no digital route for Comcare at all. That is not confirmed either way.
- Neither icare nor WorkSafe Victoria could be read from its own site for this page, because the icare provider pages refused a fetch and no invoicing page was located on the WorkSafe Victoria site. The timing and remittance facts here rest on the gateway's documentation rather than on the schemes' own.
- Pre approval is described in the corpus as required for treatment beyond the initial allowance. The developer portal records a quote facility on the WorkSafe Victoria and QBE integrations and none on icare and Comcare, but no scheme's published approval window was read for this page.
- Whether any of these schemes has used the option in s38-60 to agree not to treat its supplies as GST free is unverified per scheme, which is what the canonical template asks a practice to confirm.
- The bank narration each scheme and the gateway use is not published, so the matcher learns the descriptor from the practice's own feed rather than from a fixed string.
- The current top five for the target query was read through a real time search delegate rather than through this session's own search tool, because the search budget was spent, so that ranking is indicative rather than measured.
- GST and health: supply of services through a third party
Australian Taxation Office. Retrieved 3 Sep 2026. Source updated 12 Jun 2024.
primary
- GST and health: medical services, including medical reports
Australian Taxation Office. Retrieved 3 Sep 2026. Source updated 12 Jun 2024.
primary
- How to simplify workers compensation and CTP invoicing for your practice
Tyro Health. Retrieved 2 Sep 2026. Source updated 20 Jul 2026.
secondary
- Setting up HICAPS with Halaxy: claims, payments and reconciliation
My Great Bookkeeper. Retrieved 2 Sep 2026. Source updated 25 Dec 2025.
secondary
Review
Last reviewed 3 Sep 2026 by Shane
General information for Australian allied health practices, not tax advice. Confirm a treatment with your BAS agent or accountant before you post it.
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