DVA: Member management

This guide explains how to set up a DVA Community Nursing recipient's profile, funding scheme, referral plans, Service Agreement, care plan and matching requirements. With these in place, Visits can be delivered, 28-day episodes tracked, and claims submitted to DVA through Medicare in line with DVA requirements.

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Overview

Once your setup and configuration are complete, you can create Members and manage their DVA information. This article walks a Staffer through eight steps:

1. Creating the Member and their Membership
2. Adding the DVA funding scheme
3. Adding the Member's DVA referral plans
4. Recording consent on a Service Agreement
5. Recording Goals and Care Planning
6. Adding matching requirements
7. Monitoring 28-day episodes and claims
8. Offboarding a DVA Member

 

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Before you start

To complete this process, make sure:

• You have Staffer access to the web app.
• DVA is fully set up, including the funding scheme, service types, Membership plans, funder profile and claiming provider number (see DVA: Set up and configuration).
• You have the Member's DVA client file number, their name exactly as DVA holds it, and their gender.
• You know whether the Member holds a Gold or White Card, and for a White Card, the accepted condition.
• You have the GP or specialist referral, with the referrer's name and provider number, the referral date and the referral period.
• A DVA Membership plan is available to assign to the Member.
• You know how to create a profile and manage Member records.
• You know whether your organisation uses the Member contacts & dashboard enhancements, and if you're not sure, you can check the Release Hub or ask your Admin.
  
  

 

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Step-by-step instructions

Step 1: Create the Member and their Membership

• Click Members from the Main menu navigation bar.
• Select + New membership.

 

If your organisation has turned on Member contacts & dashboard enhancements:

The new Membership form is one page with several sections:

• Member: Enter the Member's personal and contact details, or search for an existing profile. Choose whether they receive statements and whether to send them an invitation to the app.
• Contacts: Add the people who support the Member, such as family, a carer or a representative, along with their roles and permissions.
• How is this membership funded?:
  • Under Funding scheme, select DVA. Lookout automatically suggests the funder your organisation usually uses for DVA. Check it's your DVA funder profile, or search for the correct one.
  • Tick Set up the funding scheme now to enter the DVA details straight away: Client file number, Given name, Family name, Gender and White card holder (see the table in Step 2). If you don't have them yet, leave the box unticked and add them later in Step 2.
• Other settings:
  • Select the Community (for example, DVA Members) and the DVA Membership plan. Both are required.
  • Add the signed-up date, commencement date and next review date if needed.
  • Add any cohorts and tickets.
  • Under Matching requirements, select your DVA requisite.
• Click Save.

 

Without the enhancements:

• Enter the Member's personal and contact details to create a new Member, or select an existing profile.
• Under Funder, select Other (including Services Australia, NDIS or a plan manager), then search for and select your organisation's DVA funder profile.
• Fill in the other mandatory fields marked with a red asterisk (*), such as Communities (for example, DVA Members) and public holiday preferences.
• Select the DVA Membership plan configured by your Admin.
• Click Save.

 

Step 2: Add the DVA funding scheme

A Member record holds the client's details, funding and everything needed to schedule and claim their services. For DVA clients, the funding scheme must be set to DVA, and the client's details must match the details DVA holds. Lookout uses the client file number on every line of your DVA claims export.

• From the Member's dashboard, open ⚙ Settings and click Funding scheme.
• Select Link funder, then search for your organisation's DVA funder profile and select it.
• Select Add funding scheme and choose DVA from Funding scheme.
• Complete the Further details section (see the table below).
• Click Save.

Field	What to enter
Client file number	The Member's DVA file number, as shown on their Veteran Card. It starts with a state letter (N, V, Q, S, W or T) followed by letters and numbers, for example NX123456. Lookout won't save a number in the wrong format.
Given name	The Member's given name exactly as DVA has it.
Family name	The Member's family name exactly as DVA has it.
Gender	Male, Female, Indeterminate or Unknown, as DVA has it recorded.
White card holder	Select Yes if the Member holds a White Card, or No for Gold Card holders.
Condition details	Shown only for White Card holders, and required for them. Enter the accepted condition the services relate to.

 

As a result:

• Removing DVA funding from a Member will stop their episodes appearing in future claims exports, and claim uploads for them will be rejected.
• Changing a Member's funding to DVA may cause their earlier non-DVA Visits to be counted in a DVA episode.

If a Member's funding arrangement changes, contact your Lookout representative before making any updates. Once the funding record is saved, the DVA referral plans card appears on the Member's dashboard, and a Current episode line is added to their funding details.

 

Step 3: Add the Member's DVA referral plans

A DVA referral plan records the GP or specialist referral that authorises Community Nursing services. It covers who referred the Member, when, and for which period. The referral plan does two jobs. It supplies the referrer's provider number for every claim, and its Period start date sets the start of the Member's 28-day claiming episodes.

• From the Member's dashboard, scroll to the DVA referral plans card and click View all.
• Select Add referral plan.
• Complete the fields (see the table below).
• Click Submit.

Field	What to enter
Referrer name	The name of the GP or specialist who made the referral.
Provider number	The referrer's provider number, up to 8 characters. It's printed on every claim line for this Member.
Provider type	General Practitioner or Specialist.
Period type	Standard, Non-standard or Indefinite, as shown on the referral.
Period length (in months)	Shown only for Non-standard referrals, and required for them. Enter the number of months the referral covers.
Referral date	The date the referral was written.
Period start date	The date the referral period starts. This sets the start of the first 28-day episode.
Period end date	The date the referral period ends. It can't be before the start date. Leave it blank for an Indefinite referral.

Each referral plan shows as Current, Future or Past based on its period dates. The DVA referral plans card on the Member's dashboard shows only current plans, with the referrer name, provider type and referral date. Click View all to see the rest.

Important considerations:

• Episode dates are determined by the earliest active referral
  Episodes are calculated from the earliest referral plan that has not been archived. They continue in consecutive 28-day blocks from that referral's Period Start Date, even after the referral itself has ended. Before archiving an old referral during a renewal, confirm the change with your Finance team, as archiving can shift the episode start date and alter the Member's entire claim cycle. To help prevent unintended changes, Lookout displays a warning when you archive a referral plan or save updates to an existing one.

• Referral details must align with the claim episode
  When a claim is uploaded, Lookout verifies that the Member has a referral plan covering the start date of the relevant episode and that the referral's provider number matches the provider number on the claim line. To avoid claim rejections, enter referral dates and provider numbers exactly as they appear on the referral and ensure any renewed referral has been added to Lookout before claiming services against its episodes.

 

How claims are calculated: At the end of each 28-day episode, Lookout looks at the Member's completed Visits that started within it. It then works out the claim lines:

• Core and add-on items: Lookout counts the clinical care and personal care Visits. The care type with more Visits becomes the core item, and the other becomes the add-on item. If the counts are equal, clinical care is the core item. The item number depends on how many Visits there were and their average rostered length (20 minutes or less, or 21 minutes or more, for clinical care).
• Overnight care: Each overnight Visit is claimed as its own line, based on its rostered length and whether it was active or inactive.
• Other items: Other DVA Visits are listed one per line with their actual hours and a $0 amount, so your Finance team can check and price them.
• Worker type: Clinical care lines are marked as Registered Nurse and personal care lines as Nursing Support Staff. This comes from the service type on the Visit, not from the Helper who delivered it.
• Rates: Amounts come from DVA's Community Nursing fee schedule, which Lookout keeps up to date.

Example: A Member's episode runs from 1 August to 28 August. They have eight 30-minute clinical care Visits and three personal care Visits. Clinical care has more Visits, so the episode is claimed as one clinical core item for 5 to 9 Visits of 21 minutes or more, plus one personal care add-on item for 1 to 5 Visits.

 

Step 4: Record consent on a Service Agreement

• View the Member's dashboard and scroll to the Agreement requests card.
• Select Create request to generate a new agreement ticket.
• Review the generated Agreement with the Member.
• Select Approve once all parties have given consent.

A Service Agreement records the Member's consent to receive services. Create and review the agreement with the Member and, where applicable, their representative. Approve it once everyone has agreed. For DVA clients, make sure the agreement describes the Community Nursing services they've been referred for and the referral period they're covered by. For White Card holders, also make sure it states the accepted condition the services relate to. Create a new agreement whenever these change.

 

Step 5: Record Goals and Care Planning

• Open the Member's Care plan tab from the Member's dashboard.
• Add entries to the relevant care plan categories.

The Care Plan uses custom categories to capture important information about each Member. For DVA clients, the care plan can record the clinical and personal care needs in the Member's referral and nursing assessment, along with the information Helpers need to deliver care safely and consistently.

Care plan considerations:

• Match the care plan to the Member's referral, so Helpers know which clinical and personal care tasks are in scope.
• Record risks, medications, health conditions, wound care and home safety details so care is delivered safely and you meet your duty of care.
• For White Card holders, make clear which needs relate to the accepted condition.
• Review and update the care plan whenever the Member's circumstances, needs or referral change.
• Consider whether details about the Member's carer, family or ex-service organisation contacts belong in Key Contacts rather than in care plan categories that all Helpers can see.

 

Step 6: Configure Member Requisites

Create the matching requirement in ⚙ Settings:

• From your home dashboard, open ⚙ Settings. Under Verifications, click Requisites.
• Select + New requisite
• Enter a Title, such as DVA Community Nursing – Registered Nurse.
• Under Verification, select the verifications required, such as current professional registration, a National Police Check and First Aid/CPR.
• Click Save.

Add the DVA matching requirement to the Member:

• View the Member's dashboard and scroll to the Matching card.
• Next to Requisites, click Edit and select your DVA requisite, along with any other requirements the Member needs.
• Click Save.

Only Helpers who meet the assigned requirements will appear as eligible matches. Existing arrangements that no longer meet the requirements will be flagged.

 

Step 7: Monitor 28-day episodes and claims

Once a Member has a DVA funding scheme and a referral plan, you can follow their claiming progress from their dashboard.

• Current episode: In the Member's funding details, Current episode shows how far through the current 28-day episode the Member is. Click View all to open DVA episodes.
• DVA episodes: This page shows the earliest referral plan that episodes are counted from. For each episode it lists the start and end dates, the number of Visits and the claim status: None if not yet claimed, Pending while waiting on Medicare, or the Medicare result.
• View claims: On the DVA referral plans card, click View claims to see every claim submitted for the Member. Each claim shows its status, any errors, the Medicare status and claim ID, and the expected and actual amounts.

 

Step 8: Offboarding a DVA Member (Optional)

When a Member stops receiving services, archive their Membership. Archiving hides them from searches and reports, but doesn't cancel their Visits, schedules or surveys, so clear those first.

• Open Archive Membership:
  • With the Member contacts & dashboard enhancements turned on, go to ⚙ Settings → Account → Danger zone → Archive.
  • Without the enhancements, go to Danger zone → Archive Membership at the bottom of the Member's dashboard.
  • Enter the exit details. Enter the exit date and time, select an archive reason, and review any red warnings.
• Resolve any warnings:
  • Recurring Visits: End schedules before the exit date.
  • Future Visits: Cancel any Visits after the exit date.
  • Group Activities: Remove the Member from future sessions.
  • Surveys: Mark active or incomplete surveys as Inactive.
• Complete the archive: Return to Archive Membership, confirm the details, and select Save.
• Finalise the account: Make sure the Member's last episode has finished and has been claimed through the DVA claims export. Then check on View claims that every claim has been accepted. Then, on the Finances tab, select Close Account.
• Optional: Add custom archive reasons via ⚙ Settings → Archive reasons.

 

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Ongoing management considerations

Keep referrals current: Add renewed referrals before the current referral ends.

Create a new referral for each renewal: Record renewals as new referral plans rather than updating existing ones.

Archive referral plans carefully: The earliest unarchived referral determines the Member's 28-day episode cycle. Check with your Finance team before archiving older referrals.

Review start date changes carefully: Changing the period start date of the earliest referral will move all future episodes.

Monitor long leave periods: Members on Indefinite referrals who are on leave for 28 days or more may require a referral review.

Use the correct DVA service types: Visit service types determine how services are classified and claimed.

Keep Member and referral details accurate: Ensure client file numbers, Member details, and provider numbers match DVA records to avoid claim issues.

Keep DVA and non-DVA services separate: Do not roster non-DVA services against a DVA Membership.

Be cautious when changing funding: Removing the funder also removes the DVA funding scheme when DVA enhancements are enabled.

Remember that changes are audited: Updates to funding details and referral plans are recorded in the Member's audit history.

Resolve outstanding items before archiving: Complete recurring schedules, surveys, and Visits before archiving a Member.

 

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What happens next?

The Member is now fully onboarded and ready for service delivery. From here:

• Visits can be rostered and delivered using the correct DVA service types, within the Member's referral period.
• Lookout tracks 28-day episodes from the referral plan's period start date. You can follow progress under Current episode and DVA episodes on the Member's dashboard.
• Completed episodes become ready to claim through the weekly DVA claims export.
• Referrals need to stay current. Use the DVA referral plans report to find referrals that are ending soon, and add renewals before their episodes are claimed.
  
  

-> To learn how to deliver Visits and submit claims to DVA through Medicare, continue to DVA: Service delivery and claiming.

 

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What Staffers, Members and Helpers will see

For Staffers

Staffers can use the Member's dashboard to view and update Funding, DVA referral plans, DVA episodes and claims, Agreements, Goals and Care Plan information. They can also run DVA reports from Reports.

For Members on the Lookout app

• Members can view their own Care Plan and Goals, along with recorded risks, conditions and other categories, where sharing is turned on.
• Members and their authorised representatives can also view statements, manage payment details, respond to surveys and request Visits.
  
  

For Helpers on the Lookout app

• Helpers can open each Member they support and view their Care Plan, including Goals, risks, conditions, medications, allergies and any custom categories you've set up.
• Helpers can view their scheduled Visits, the services to deliver, and shared check-out notes or care forms where these are turned on.
• Helpers can't see the Member's DVA client file number, referral plans, episodes or claims. Only Staffers can see these.

 

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Troubleshooting

I can't see the DVA referral plans card

• Check your Access role.
• Confirm the Member has an active Membership with a DVA funding scheme saved. The DVA referral plans card only appears after DVA is saved.
• Try logging out and back in.

 

The funding scheme won't save

• Check that Client file number, Given name, Family name and Gender are all filled in.
• Check that the client file number starts with N, V, Q, S, W or T, uses capital letters and matches the format on the Member's DVA card, for example NX123456.
• If White card holder is set to Yes, check that Condition details is filled in.

 

The referral plan won't save

• If you see "is before the period start date", check that the Period end date is on or after the Period start date.
• If the Period type is Non-standard, check that Period length (in months) is filled in.
• Check that the provider number is no longer than 8 characters.

 

The DVA episodes page says an active referral plan is required

The Member has no referral plan that hasn't been archived. Add the Member's referral plan in Step 3. Archived plans can't be edited.

 

A Member is missing from the DVA claims export

• Check the Member has a DVA funding scheme and at least one referral plan that hasn't been archived.
• Check that one of their 28-day episodes ended in the week you selected. The DVA episodes page shows each episode's end date.
• Check the Member's Visits in that episode are marked as completed.

 

A claim upload says the referral plan or funding scheme could not be found

• "DVA Funding Scheme could not be found": the Member's funding scheme is no longer DVA. Contact your Lookout representative.
• "DVA Referral Plan could not be found": the Member has no referral plan covering the start of that episode with the same provider number as the claim line. Check the referral's dates and provider number, or add the renewed referral.

 

I can't upload claims and see a provider number message

If you see "Your provider number has not yet been registered", your organisation isn't set up to submit DVA claims yet. Contact Lookout support.

 

I completed the steps, but nothing changed

• Make sure you clicked Save or Submit on each page.
• Check for any error messages on the page.
• Contact support if the issue continues.
  
  

 

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Still need help?

If you're still having issues, contact our support team and include:

• Screenshots, if possible
• The user's name and email
• The exact steps you took
• Any error messages you received