- All provider claims should be made in the myplace provider portal.
- We will continue to use the myplace provider portal for claims while participants transition to our new computer system.
- Claims from my providers are generally paid within 2 to 3 days.
- Pricing arrangements and limits are same for participants everywhere. They don’t change with our new computer system.
Providers should use the myplace provider portal to manage all their financial transactions with the NDIA, including:
- Making payment claims
- Raising payment enquiry tickets.
There are no changes to how providers make claims in the myplace provider portal, support item descriptions, or the codes used to make claims.
One new support type and 6 new support categories have been added to NDIS plans in our new computer system.
Providers should continue to use the existing 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.
To make sure our language is consistent across NDIS plans and portals, the name of the 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.
Bulk payment claims
As participants and their plans move to our new computer system, providers will not be able to use the single line-item claim function.
All claims will need to be made in the current myplace portal with the same service and support details used now.
Claims will need to be made using the:
Providers should consider adjusting their business practices to submit all single claims via the bulk upload process. If providers use the bulk payment request template, they don’t need to understand if a participant has an NDIS plan in our new computer system because all claims should be made through the myplace provider portal.
Using the bulk uploads process will also reduce the likelihood of providers receiving single claim error messages, duplicating processes, and experiencing payment delays.
Providers can watch our video on making bulk payment claims to learn more:
Payments – for providers recorded as a my provider
Payments for Agency-managed plans and supports from my providers are generally paid within 2 to 3 days.
Payments – for providers not recorded as a my provider
When a payment claim is made:
- on an NDIA-managed plan or support and
- from a provider who is not recorded as a my provider
We will check with the participant or their nominee by SMS to make sure:
- the support was agreed to
- the claim has valid details
- the participant or their nominee has agreed to the support.
Valid claims on Agency-managed plans or supports from providers who are not recorded as a my provider generally take 10 days to be paid.
Claims from providers for specialist disability accommodation, home and living supports and behaviour supports who aren't listed as a my provider for the participant's plan will be automatically rejected.
Cancelling claims
Providers can cancel claims in the myplace provider portal for participants who have a NDIS plan in our new computer system.
Providers who make a mistake with a payment request can cancel the claim, when it is “pending” or “paid”.
Providers should follow the myplace provider portal step-by-step guide to cancel their claim.
The process to cancel these claims in the myplace portal is the same for all NDIS plans, regardless of whether they are in our new or old computer system.
Rejected claims – errors
If a claim is rejected, providers will see advice in the myplace provider portal which shows the reason why the claim has not been processed.
The majority of claim payment errors can be corrected by providers in the myplace provider portal.
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.
If a provider's claim is rejected, or if they receive an error message, they can refer to the bulk payments request self-help guide for more information:
Rejected claims – supports not agreed
Providers who are supporting an NDIA managed participant with an NDIS plan in the new computer system, and are not recorded as a my provider, will not receive an error code while their claim is being checked. The claim will remain as ‘open’ until it is paid or rejected. This means some claims may have an ‘open’ status for up to 10 days.
When we check with a participant, and they tell us they have not received a claimed support, we will pause the payment and review the claim. Claims that are not authorised for payment will be marked as ‘rejected’ in the portal.
When a claim is rejected, providers won’t be able to see the participant’s name. The rejected claim will display the participant’s NDIS number only.
Claims from providers for Agency-managed specialist disability accommodation, home and living supports and behaviour supports who aren't listed as a my provider for the participant's plan will be automatically rejected.
Self-managed or plan-managed specialist disability accommodation and behaviour supports must be delivered by providers who are registered with the NDIS Quality and Safeguards Commission.
Claiming for services after the end date of plan
Plan managers can only submit claims for supports delivered within their current plan-management period.
Plan managers need to make sure they submit any claims before their plan management period on a participant’s plan ends.
Claims for participants who have left the NDIS
Providers can still claim for supports purchased before the participant has left the NDIS under a service agreement. We recommend claiming within 90 days from the participant's date of leaving the NDIS, or of the participant's death.
If a provider is claiming for services delivered after the participant has left the NDIS, the claim will be rejected, and the provider will need to contact the Agency to have it reviewed.
Claims and payments checklist
Follow this checklist to help solve queries you may have about claims and payments.
Frequently asked questions – trending claiming issues
Message displayed
The service provider is either not listed under the participant’s my provider list for the specific support category, or they are on the list but not for the support dates.
What does it mean?
You have tried to create a claim for Agency managed specialist disability accommodation, home and living supports or behaviour supports without being recorded in the participant’s my provider list.
What should you do?
Providers need to be recorded as a my provider by the participant or nominee to be paid for these supports.
Providers can check the my NDIS provider portal to see if they have a my provider relationship recorded against the participant’s plan.
Providers should connect with participants and nominees to ensure they are recorded correctly.
Message displayed
The plan management type for this support category cannot be claimed by the service provider. If you have any questions, you can contact us on 1800 800 110.
What does it mean?
You have either tried to create a payment request for a support item that is:
- Self-managed in the participant's plan
- Plan-managed in the participant’s plan, and you do not hold the role of plan manager for the entire period claimed.
What should you do?
Check that you have selected the correct support item.
Contact the participant to confirm the funds management type for the support.
Where supports are plan-managed, confirm the plan manager with the participant.
Self-service – plan managers working with participants
Plan managers can request, through the my NDIS provider portal, that a participant would like to record them as a plan manager on their plan.
Message displayed
There are insufficient funds in the plan budget for the claimed support. Please review the claim and the available budget. If you have any questions, you can contact us on 1800 800 110.
What does it mean?
The payment amount you have requested is more than the available budget.
What should you do?
Contact the participant, nominee or support coordinator regarding funding allocated within the participant’s plan.
Message displayed
The support is not available for the dates entered. Please review and try again. If you have any questions, you can contact us on 1800 800 110.
What does it mean?
You have submitted a claim outside the participant’s plan dates.
What should you do?
Log into the my NDIS provider portal and check the start date and the end date for the claim is valid and within the plan dates.
Create a bulk load template with the correct start date and end date and then upload to the myplace provider portal to finalise your claim.
The start and end dates must be in the format YYYY-MM-DD.
Message displayed
The value of this claim is either $0 or below $0, or the unit price claimed is above the NDIS unit price.
What does it mean?
The unit price entered on this payment request is not a valid price. The unit price exceeds the price of the support line item approved in the pricing arrangement.
What should you do?
Check that you have entered the correct unit price in the bulk load template and that the unit price is formatted as 0.00.
Providers should review pricing arrangements and limits to identify 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.
Message displayed
This claim has been identified as a duplicate. Please review the claim history.
What does it mean?
You have tried to create a claim for the same service provided to the participant more than once.
What should you do?
Check that you have entered the payment request details correctly.
Review your claim to make sure the supports have only been claimed once.
Providers should raise claims and payment queries through the myplace provider portal. A dedicated claims and payment team will action these queries.
Please call the National Contact Centre on 1800 800 110 for further support or discuss claim details further with the participant you are supporting.