Agency settings determine how claims that have been sent for approval are handled: - Lead Time - How many days the claim will stay open to approve or reject - The claim process when the lead time expires (no action taken)
Claim Approval Lead Time
The number of days claims stay open for approval is determined by the agency.
The default lead time is set at 14 days, but agencies have the option to request a shorter or longer period.
The selected approver will receive an initial approval request by email, then a further reminder email each day until action is taken or the lead time expires. Both emails display the number of days remaining.
Claim process when the Lead Time has Expired (no action taken)
If no action is taken by the approver before the end of the approval period
- by default the claim will Auto Approve and submit to the NDIS (unless the claim is Held for Review).
eg: Claim Approval is set to 3 days and no action is taken by approver:
Approval request sent = Day 1. The claim will submit at 6am on Day 3
- An approval request email is sent when submitted on Monday (Day 1).
- The Approver will receive an approval reminder email at 7am on Tuesday (Day 2)
- The Claim will auto approve and submit at 6am Wednesday (Day 3).
Alternatively, an agency can opt to have claims:
- Auto Reject
eg: Claim Approval is set to 3 days and no action is taken by approver:
Approval request sent = Day 1. The claim will Reject at 6am on Day 3
- An approval request email is sent when submitted on Monday (Day 1).
- The Approver will receive an approval reminder email at 7am on Tuesday (Day 2)
- The Claim will auto reject at 6am Wednesday (Day 3).
Alternatively, an agency can opt to have claims:
- Move to Claims with Issues
eg: Claim Approval is set to 3 days and no action is taken by approver:
Approval request sent = Day 1. The claim will move to Claims with Issues at 6am on Day 3
- An approval request email is sent when submitted on Monday (Day 1).
- The Approver will receive an approval reminder email at 7am on Tuesday (Day 2)
- The Claim will move to Claims with Issues at 6am Wednesday (Day 3).
In this instance an email is sent to the Plan Manager to notify them:
If you would like to change from the current default setting please email support@credsys.com.au
The selected setting will apply to ALL approval requests handled by the agency.
Related Article: Request Approval of a Claim