View claims with issues that need to be addressed.
Claims with Issues This will identify any claim with an issue that needs to be addressed. These are claims that are in an approved or entered status that:
- has at least one rejected claim line;
- and/or at least one claim line where an exception was raised by NDIS which has prevented the provision of a PRN.
- and/or a short paid claim line that may require an adjustment claim.
- was approved but still held for review which has prevented the claim from submitting
- no action taken on approval request (if agency setting is to move claim to claims with issues instead of auto-submitting).
If the response from NDIS to a submitted claim is either a rejection or an exception, the claim will be displayed in the list until the issue has been rectified.
Claim lines that have been short paid by more than $1.00 will display an option to add an adjustment claim. This is generally handled at the time of submission, but during the period that the adjustment is available and until the amount has been claimed, the claim will be added to the Claims with Issues list as it requires attention.
NOTE: If a claim line has been short paid and you do not add an adjustment claim before the NDIS processes the payment, the claim will be removed from the Claims with Issues list, and you will lose the opportunity to submit an adjustment claim for that line.
(An automatic adjustment will be applied if the amount is <= $1.00).
Claims with Issues is different to Override claims. Override Claims holds claims that have a rejected or cancelled claim line. They need to be checked and updated and/or payment enabled.
Next Read: Override Claims