Some improvements to help with handling partial payments from NDIS and the impact on claim line calculations Security enhancement Update to the Claim Line Report
This week there are a some improvements to help with handling partial payments from NDIS and the impact that has on claim line calculations, a useful security enhancement and an update to the Claim Line Report to help match up with NDIA remittance advice reports.
- Adding adjustments to partially paid line items
- Claim Total vs Invoice Total
- Two Factor Authentication
- Claim Line Report: Date filter - Date Paid
Adding Adjustments to partially paid line items
If a support item is short paid by NDIS, you can now add an Adjustment to the claim straight from the Claim Details page.
The Claim Details page will alert you to a partial payment on a claim. Use the Adjustment feature to correct the Claim.
To use the Adjustment feature scroll down through the Added Services. The Support Item will be identified with an Alert - the NDIS Pay Amount is different from the Claim Amount:
Select Add Adjustment
The Quantity field will show a unit of 1 and the Unit Price will show the adjustment amount (the difference between the original amount claimed and the amount paid by NDIS).
You will not be able to enter an amount higher than the amount displayed as that would increase the overall Claim amount. You can adjust the Quantity and the unit price as long as the total does not exceed the adjustment amount.
When you Claim, the adjustment will be claimed immediately - you do not need to resubmit the claim.
The adjustment amount applied will show under the Support item:
It has been claimed using the same support item code, dates and claim type and will show the Payment Reference number and amount. In PRODA, it will have the invoice number with #GAP appended i.e. Inv123#GAP, where all other claim lines without an adjustment would simply be Inv123.
The Pay Amount will now equal the Invoice Total:
Claim Total vs Invoice Total
When a claim gets partially paid by the NDIS, we display the Claim Total as well as the Invoice Total, which may calculate differently if you do not use the adjustment method mentioned above.
The Claim Total represents the total amount that has been submitted to NDIS in the claim lines, excluding any cancelled or rejected lines. If a line item is rejected or cancelled, we expect you will be adding another replacement line item, so the invoice total will be made up of the correct claim lines.
If you were to submit another support item instead of applying an Adjustment, the Claim Total and Invoice Total would now include the original claim amount, plus the new additional claim and may not then reflect the actual Invoice amount. You can manually overwrite the Invoice Total if required.
In this example, we have submitted a claim which had a partial payment, we then added a new support item to make up the short payment and re-submitted it to NDIS.
The Claim Total now includes the original claim amount plus the newly submitted item. This is the full amount that has been claimed regardless of the claim status.
The Invoice Total will match the Claim Total, but can now be adjusted to reflect the actual Invoice amount - the amount that has been claimed after all adjustments have been made - and should match the invoice file submitted by the Provider.
Two Factor Authentication
Two Factor Authentication is now available as an option for any individual user when logging into the Planability system. We recommend all users have 2FA switched on but have left this option for you to control.
Directors can enable Two Factor Authentication for Plan Managers.
The authentication code will be sent to the user's email address.
Claim Line Report: Date filter - Date Paid
We have added an additional filter to the Date Filter Type: You can now filter by the date of the NDIS Payment. This will be most useful when matching a payment from the NDIS and exporting the specific line items from Planability.
