Monthly Claims - Plan Management Fees

Table of Contents:
Monthly Fee Automation
Participants to be invoiced
Participants with issues (including Monthly Fee Claim Amount Threshold)
Participants with auto monthly invoicing off
Participants with generated invoices
Create a Payment Batch for Plan Management fees

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Monthly Claims can be accessed by Directors and Plan Managers with elevated Claims permission.

When adding a new Participant to Planability you will have missed the automated claiming for the month. Please navigate to Claims > Monthly Claims to generate claims for any new participants: see Participants to be invoiced

Monthly Fee Automation

Auto Monthly Fees - Agency setting to claim for current month or prior month

Agencies have the option to choose whether the automated claims for monthly fees which are processed on the 1st day of the month are for the current month or for the prior month.

• 1st day of the month - claim for the current month. Eg 01 April 2025, claim is for April 2025
• 1st day of the month - claim for the prior month. Eg 01 April 2025, claim is for March 2025

For Plan Management fee claims made on the 1st day for the current month, the service dates will be for ONE day only. They will show as:

Support Start Date: 1st/mm/yyyy

Support End Date: 1st/mm/yyyy

For Plan Management fee claims made on the 1st day for the prior month, the service dates will be for the full month:

Support Start Date: 1st/mm/yyyy

Support End Date: last/mm/yyyy

Participants to be invoiced

Agency setting is for auto claims on 1st/mm/yyyy - Current Month

If the agency setting is configured to automatically generate claims on the 1st of each month for the current month, it is important to note that when you add a new Participant during that month, you will need to manually generate a claim for their first month. This is because the auto generation of claims does not include participants who were added after the process has already taken place.

These participants will be listed under Participants to be invoiced. To generate a claim for their monthly fees:

1. Select Claims > Monthly Claims
2. Select the participants via the checkbox to the left of their name or all from the top checkbox; and
3. Generate Monthly Invoices.

You can manually generate claims for participants at any time during the month using this process. 

Agency setting is for auto claims on 1st/mm/yyyy - Prior Month 

If the agency setting is for claims to be auto-generated for the prior month, Planability will generate and submit by batch claim, claims for all participants who are:

• active in Planabilty;
• have budget available as per your agency threshold; and
• have 'Auto Invoicing' selected on their profile.

Participants with issues

This section identifies any participants who have either insufficient budget for your agency monthly claim threshold or no Service Booking with item 14_034_0127_8_3.

Monthly Fee Claim Amount Threshold (also known as Auto-Approve Limit)

While the standard non-remote monthly fee claim is $104.45, there are scenarios where you may have a lesser amount to claim. If you are utilising automatic monthly fee claim generation, you may choose to set a custom threshold for your agency. For example, if you are happy for Planability to automatically generate any monthly fee claims above $100, you may set the threshold to this so any applicable claims will follow the standard monthly fee process claim on the 1st of each month without requiring intervention or adjustment.

You can view your current agency threshold on the Monthly Claims page:

Budget Issue - Some Funds Remaining

'Budget shortage for item 14_034_0127_8_3. Item remaining amount $XX.XX'

If the remaining available funds for the Participant are less than your agency Monthly Fee Claim Amount Threshold but more than $0.00, you may still choose to generate a claim for them. To do this:

1. On the Monthly Claims page, navigate to the 'With Issues' tab.
2. Locate the relevant Participant in the list. There will be a flag to the far right of any Participants who have some funds available but fall under your agency threshold.
   
   
3. You should see a checkbox to the left of the Participant name. Check this box to add them to your 'To be invoiced' tab using the available budget amount. A flag will appear on the 'To be invoiced' tab for each Participant you select the checkbox for. 
   
   
4. Once you have repeated this process as necessary, click the 'Generate Monthly Invoices' button to create and submit the claims.

Budget Issue - No Funds Remaining

'Budget shortage for item 14_034_0127_8_3. Item remaining amount $0.00'

Check the plan end date - if it is ending this month, when the new plan is found, or this plan is extended you will be able to claim from 'To Be Invoiced' tab when there is available budget.

This may also appear if the Participant has funding periods that do not align with the first of the month. In these cases, the Participant will automatically move from the 'With Issues' tab to the 'To be invoiced' tab when the funding period funds are released.

Service Booking Issues

'No service booking with item 14_034_0127_8_3'

Once a Service Booking has been created that includes the relevant dates, the participant will move to 'To Be Invoiced' tab. You can generate the claim from there.

Participants with auto monthly invoicing off 

This section displays any participants who do not have the opt-in setting for 'Auto Invoicing' selected. This helps to identify any Participants who may not be currently included in the auto-generation of Monthly Claims.

(Note: You can review all opt-in settings for Participants and associated contacts using the Participant Records report).

Participants with generated invoices

All Participants who have had a claim submitted for their monthly plan management fees in the current month will display in Participants with Generated Invoices. Their status will initially show as Batch Submitted, then Claimed and then NDIS Paid when the claim has been processed and paid.

Create a Payment Batch for Plan Management fees

For both Auto invoices and Generated Invoices you will need to create a Batch Payment to clear them from your Payments or to transfer them to another bank account.

When the claims are marked as NDIS Paid create a Batch Payment to mark them as Paid to the Provider (your Agency). Download the ABA file to mark the claims as Paid. If you need to transfer these payments to another account upload the ABA file to your bank to make the payment transfer. If the funds do not need to be moved you need not take any further action.

All monthly Invoices have the format:

NDISNumber_YearMonth_DayHourMinute

eg: 43xxxxxxx-YYMM-DDHHMM