Submit a claim to the NDIS using the Planability real-time claim submission and view the NDIS response for each claim line.
Table of Contents:
Submit Claim
Claim issues
- Short payment? Add Adjustment
- Claim Line rejected? Edit and resubmit claim line
Planability offers two methods t submit a claim to the NDIS choose to Submit Claim or Mark for Batch Claim.
Submit Claim - uses the NDIS APIs to submit the claim immediately with the NDIS. Upon submitting, the Participant budget updates in both PRODA and Planability immediately and a response is received for each submitted claim line. The NDIS response includes the PRN (Payment Reference Number) and NDIS Pay amount.
Batch Claim - Claims for services provided more than 90 days after a Plan or Service Booking has ended must be submitted by Batch Claims. Claims can be submitted in bulk to the NDIS using Batch Claims.
See: Batch Claims for further detail
Submit Claim
Claims are submitted from the Claim Details page.
The Claim Details page displays the Claim information and added services, the invoice total (sum of added services) and the Document Preview.
Each Support Item will display showing the Claim Amount. The Pay Amount will be blank until submitted and the Claim Status will be Entered.
- Click Submit Claim
The claim Status will update to Submitted
Each Claim Line will be udated with the NDIS PRN and the status will be Claimed.
Whilst the claim will have been through all the Planability checks / guardrails to prevent any errors or short payments, we recommend checking the status of the claim lines to verify if any further action needs to be taken.
If a short payment has been received, Planability will offer an 'Add Adjustment' option.
Short Payment can occur for items with no published price limit or if the NDIS has a different price zone recorded for the participant.
Claim Issues:
Add Adjustment
If the NDIS response on the claim line indicates a short payment, this will be identified on the Claim Details page as soon as the claim is submitted and the response received:
1. The Claim information identifies the issue. If no adjustment claim is required you can edit the Invoice total amount to match the pay amount. When payment is received from the NDIS the claim will be Payable to the provider or participant.
2. In most instances an adjustment claim should be made to claim for the balance.
- Click 'Add Adjustment.
The software will calculate the amount to be claimed for the claim to be paid in full.
- Click Submit
An additional Support Item will be submitted to the NDIS, using the same Invoice number (with an addendum to avoid rejection), the same code, claim type and GST type.
a PRN is received in response and recorded under the original support item.
Support Item Rejected? Edit and Resubmit Claim Line
If a claim line is rejected by the NDIS, the claim line status will show rejected, and the claim status indicator will be Red. (grey = entered, orange = claimed, red = rejected or cancelled)
View the NDIS rejection reason by clicking on the support item code:
If the claim line can be adjusted and resubmitted, click Edit in the top right of the screenOn the Claim Edit page
- Clone or Add Claim line. Clone will create a new claim line with the existing details, you will need to select Claim Type and GST type as these fields will be blank.
- after updating the claim line information, click Add
- Click Confirm
- Resubmit Claim. The claim line that is newly entered will be submitted to the NDIS.
Check the claim line has submitted successfully:
See: Claims with Issues for more information.