On this page:
- Claims and payments in our new computer system
- Claim and payment enquiries
- System change: learning new ways of doing things
- System controls: protecting participant plans
- Using the new system: Replacement supports claims
- Using the new system: Bulk payment claims
- Using the new system: my providers
- Using the new system: Claims when a plan has ended
Claims and payments in our new computer system
Providers should continue to use the myplace provider portal to manage their financial transactions with the NDIA, including:
- submit a claim
- raise a complaint or send feedback
- view the status of claim and payment enquiries submitted in the myplace provider prior to 6 May 2024.
There are no changes to how providers make claims in the myplace provider portal, NDIS support item descriptions, or the codes used to make claims.
Providers should continue to use the existing NDIS support item descriptions or codes to make their claims. These descriptions and codes will automatically point to the relevant budgets in our new computer system.
We will continue to use the myplace provider portal while new and existing participants transition to our new computer system.
Claim and payment enquiries
Providers should use the my NDIS provider portal to submit claim and payment enquiries.
Providers can log into the my NDIS provider portal to submit their claim and payment enquiry from the enquiry page.
If a provider logs into the myplace provider portal and clicks on the ‘claim and payment enquiry’ tile they will be automatically redirected to the enquiries page of the my NDIS provider portal.
To submit a claim and payment enquiry in the my NDIS provider portal, providers will need to:
- navigate to the enquiries page
- select if it is a new enquiry or following up on a closed enquiry
- select the type of enquiry
- enter the details into the fields displayed on the screen
- click the submit button.
Providers have told us, when submitting a claim and payment enquiry in the my NDIS provider portal, the NDIS support category options don’t always relate to their issue. We recently added a new NDIS support category called ‘Other claim or payment enquiry’. When this category is selected, providers will need to add an ‘enquiry title’ and ‘enquiry description’.
For claim and payment enquiries where the ‘claims rejected’ category option is selected, providers need to submit one claim and payment enquiry per participant and include all rejected claims.
For ‘claims rejected’, ‘payment not received’ and ‘issue cancelling claims’ category options, providers need to make sure they are entering the support dates for the total period from earliest to latest.
For ‘claims rejected’ and ‘payment not received’ category options, providers need to include the total value of the claims instead of individual claim amounts.
Providers can learn more on how to submit a new claim and payment enquiry in the my NDIS provider portal in the provider learning environment and the my NDIS provider portal guide.
Providers can find more information on accessing the provider learning environment and the my NDIS provider portal on the my NDIS provider portal and resources page.
To make sure our language is consistent across NDIS plans and portals, the name of the NDIS support catalogue item in the plan will be the same name in the participant and provider portals.
Pricing arrangements and limits are the same, regardless of whether a participant’s plan is developed in our new or old computer system. Providers can keep up to date with the regular pricing updates.
System change: learning new ways of doing things
Some of the improvements we’ve introduced mean some providers may need to learn new ways of doing things or stop doing some of the things they’ve done before.
We acknowledge change can sometimes be hard, and adapting to different processes can take some time. We are committed to the changes we’ve introduced because participants, providers, the disability community and the Australian Government told us these were improvements they wanted to see and we needed to make.
We removed service bookings because participants wanted more flexibility in how they could use their funding. While service bookings gave funding surety to providers, they limited choice and control for participants.
We introduced 6 new NDIS support categories and lifted the budget to the NDIS support category level, so that participants could have more flexibility in how they purchased their NDIS supports. We will still have stated and flexible NDIS supports, and the line items for claiming does not change.
Providers should continue to use the existing NDIS support item descriptions or codes to make their claims. These descriptions and codes will automatically point to the relevant budgets in our new computer system.
System controls: protecting participant plans
The Australian Government is committed to protecting the consumer rights of participants and ensuring reasonable pricing practises.
We have improved business intelligence in our new computer system. This means we can better understand when a participant’s spending pattern is higher or lower than usual. We will work directly with them to make sure they have the funding, NDIS supports and providers in place to support their needs and goals.
Increased plan security with a new process called my providers, for participants to record their longer-term relationships with providers and when some or all of their NDIS supports are Agency-managed. When recorded as a my provider, participants are letting us know that the provider can receive payments for claims on their NDIS plan.
We have introduced an additional claim validation process for participants, so they can review payment claims submitted for their plan by providers who are not recorded as their my provider for Agency-managed NDIS supports.
We have improved our quality assurance processes and the way we manage and resolve payment claims, for faster and more consistent outcomes. We want to make sure that all claims for payment are valid, can be claimed and are recorded correctly.
Providers can be confident with the introduction of quality control measures including:
- consistent checks on claims
- removing service bookings
- introducing my providers.
We are all contributing to safeguarding the Scheme.