All claims and payments will continue to be submitted in the current myplace Provider portal.
If you are using the Bulk Payment Request template, you don’t need to understand if a participant is part of the Tasmania test or not when submitting a claim. We will continue to have one claims portal for all participants.
As participants and their plans move over to our new computer system in Tasmania, providers will not be able to use the single line-item claim function. Providers will receive an error message.
All claims will need to be made in the current myplace portal using the Bulk Payment Request template (CSV 1KB), with the same service and support details used now.
When a claim is made for payment, a number of checks are completed. We do these checks to make sure the service has been delivered, the claim has valid details and the participant, or their nominee has authorised the service.
We are testing a new claim validation process for Agency-managed participants in Tasmania.
If a participant-endorsed provider makes a claim on a participant’s plan, we will know this provider can make the claim as the participant has endorsed the provider and the payment of the claim will be automated. Participant-endorsed provider claims are generally paid within 2 to 3 days.
If a claim is made on an Agency-managed participant’s plan by someone or an organisation who is not a participant-endorsed provider, we’ll check with the participant, or their nominee, by SMS to confirm this is a service has been delivered as agreed.
If the service was agreed to by the participant, no further action is required from the participant or their nominee, and the claim will be processed for payment after 7 days. This process will generally take 10 days before the claim is paid.
If the service was not agreed to by the participant, they can contact the National Contact Centre within 7 days of receiving the SMS to let us know.
When a participant tells us they have not received a claimed service or support, we will pause the payment and review the claim.
The participant and the provider may be contacted to discuss the claim. The outcome of our review will be visible in the my NDIS portal. Claims that are not authorised for payment will be marked as ‘rejected’.
If a provider claims for Specialist Disability Accommodation and Behaviour Support services and that provider is not listed as a category level participant-endorsed provider for those specific categories, their claim will be automatically rejected.
In the Tasmania test:
- validated claims, including participant-endorsed provider claims, will be processed and usually paid within 2 to 3 days
- if claims need some additional checks before they are approved, payment will usually occur within 10 days.
If a claim is rejected, providers and self-managing participants will see advice in their portal which shows the reason why the claim has not been processed.
The majority of claim payment errors can be corrected by providers and self-managing participants in the portals.
For example, administrative errors like wrong dates, a duplicate claim, missing banking or ABN details, or the claim includes a unit price that is more than the maximum price.
Providers can refer to the system and error messages guide for more information.
Providers will not receive an error code while a payment is being verified. Where the participant does not dispute the claim, the payment will remain as ‘open’ until it is paid, which usually occurs in approximately 10 days.
Providers and self-managing participants can submit more information in their portal or contact the National Contact Centre for support.
You can read more information and answers to frequently asked questions on claims and payments on our frequently asked questions for providers in Tasmania web page.