- Providers are encouraged to check back when they are experiencing claim and payment issues to help self-solve their payment error.
- Most claim and payment errors can be corrected by providers in the myplace provider portal.
- We have introduced frequently asked questions for rejected claims – troubleshooting and guidance.
We update the information on this page regularly to support providers understand how to self-solve their payment rejections.
We have introduced frequently asked questions for rejected claims. This means if multiple providers are experiencing the same payment issue, we will update this page to include more information and the steps to self-solve their payment error.
Providers are encouraged to check back to help with claim and payment issues.
Claims and payments checklist
Providers can follow this checklist to help solve queries you may have about claims and payments.
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.
Most 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.
Frequently asked questions – general claims and payments
There are checks providers can do, to make sure their claim has been entered correctly. Providers are encouraged to follow the claims and payment checklist.
Providers with “open” or “pending” claims in the portal can:
- After 7 working days – raise a payment enquiry ticket in the my NDIS provider portal.
- After 14 working days – contact the NDIA on 1300 311 675 and seek an update on their payment enquiry.
Providers can call our National Contact Centre for further assistance or feedback.
In our new computer system, funding in NDIS plans will be built at the support category level. There will be no line items built into plans. Participants will still have stated and flexible supports, but these will be at the support category level.
Providers should refer to the support items catalogue and use the most appropriate line item for the support they have delivered. The price limits for assistive technology and home modifications are regularly updated to align with typical claims for that product type.
Providers receiving the following error message:
You have tried to enter $0 as the unit price or you have tried to make a claim above the unit price listed in the NDIS pricing arrangements and price limits.
Are encouraged to:
Check they have selected the correct support item from the current AT, HM & Consumables Code Guide.
Contact the participant to confirm the funds management type for the support they are claiming.
If claiming from plan-managed supports, ask the participant to confirm their plan manager.
Check they have entered the correct unit price in the bulk payment request template and that the unit price is formatted as 0.00.
Providers who continue to receive this error message can:
Raise a payment enquiry in the my NDIS provider portal.
Email [email protected]
Call our National Contact Centre on 1300 311 675.
The intention of service bookings was not for the monitoring of spending. While service bookings gave funding surety to providers, participants have told us they limit choice and control over how they use their plan.
To give participants more flexibility, we introduced a range of improvements that work together. These include:
- Removing service bookings, so that participants are not locked into long term support arrangements, if they don’t want to be.
- Introducing my providers so that participants with NDIA-managed supports, a plan manager, specialist disability accommodation, home and living supports and behaviours supports can tell us who these providers are. By recording my providers, participants are letting us know who can make payment claims from their NDIS plan.
- Listing budgets at the support category level as a whole dollar figure rather than line-by-line costs maximises flexibility within a category.
We acknowledge removing service bookings will be a change for some providers, however, it does not affect how we support participants to get the most out of their NDIS plans.
Providers with existing active service bookings, who deliver home and living, behaviour supports, and specialist disability accommodation, will automatically be recorded as my providers at the support category level when the participant's plan is approved in our new computer system.
A participant’s my NDIS contact can arrange a check-in with the participant, to understand their situation and if anything has changed, and if they need more, less or different supports.
You can self-service your problem with the tools and resources available on the improvement's website, such as frequently asked questions for providers, my NDIS provider portal step-by-step guide and claims and payments.
No. If providers are either directly integrating or using an aggregator for payment claims, this practise can continue in the usual way.
However, for plans in our new computer system, single claims will not be accepted via the myplace provider portal.
Providers are encouraged to adjust their business practices to submit all claims via the bulk upload process. This way, providers don't need to know whether a participant’s plan is in the new or old computer system, or have their claims rejected for reprocessing via the bulk upload approach.
Providers should refer to the Assistive Technology, Home Modifications and Consumables Code Guide for general claiming rules and information on Assistive Technology (AT) supplementary charge codes and claiming for support items where notional unit prices ($1.00) apply.
When using the Bulk Payment Request template to claim for Assistive Technology (AT) supplementary charge codes or for support items where notional unit prices ($1.00) apply, the quantity should match the value of the invoice and the unit price should be set to $1.00.
We have adjusted our new computer system to make sure participant addresses are recorded correctly and the agreed regional, remote and very remote maximum price limits are correctly applied to NDIS plans. If providers have a claim rejected, they can wait 7 days and reprocess the claim.
Providers who continue to notice a difference in agreed price limits can also let us know by raising a payment enquiry in the my NDIS provider portal.
No. Unregistered providers should continue to submit their invoices to self-managed participants or plan managers in the usual way.
Rejected claims – troubleshooting and guidance
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 to be paid for these supports.
Providers with existing active service bookings, who deliver home and living, behaviour supports, and specialist disability accommodation, will automatically be recorded as my providers at the support category level when the participant's plan is approved in our new computer system.
Providers can check the my NDIS provider portal to see if they have a my provider relationship recorded against the participant’s plan. They will also be notified in the my NDIS provider portal when they are recorded as a my provider.
Message displayed
The claimed support is self-managed for the claim period and can only be claimed by the participant.
What does it mean?
The support for the claim period is self-managed, meaning providers cannot submit claims for it.
What should I do?
Contact the participant or their nominee to verify the participant’s fund management arrangements and how payments can be received.
Or
Message displayed
The claimed support is plan managed for the claim period and can only be claimed by the participant’s plan manager.
What does it mean?
The claimed support is plan managed for this claim period, but the provider does not have the required plan manager role to submit the claim.
What should I do?
Contact the participant or their nominee to verify the participant’s fund management arrangements for this claim period. This may include obtaining details of the participant’s plan manager and how to lodge a claim for payment with that plan manager.
Message displayed
There are insufficient funds in the plan budget for the claimed support. Please review the claim and the available budget.
What does it mean?
You have tried to create a claim for a stated support item and there is not enough funding left in the participant’s budget.
Or
You have tried to create a claim for a flexible support item and there is not enough funding left in the participant’s budget.
What should you do?
Check that you have selected the correct stated support item and that there is available budget to make a claim.
Or
Check that you have selected the correct flexible support item and that there is available budget to make a claim.
Or
Contact the participant or their plan nominee, to discuss support options.
Message displayed
The support is not available for the dates entered. Please review and try again.
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 and the Bulk Payment Request template must be open when uploading the file.
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.
The home and living budget will be allocated at the category level for a participant’s plan in the new computer system.
This means that regular and irregular supports will not be separated like they are in the old computer system.
Providers should discuss with the participant how regular and irregular supports will be delivered and claimed for against their plan budget. Providers are also encouraged to include this information in their service agreements with the participant.
Claiming will continue to occur as outlined in the NDIS Pricing Arrangements and Price Limits 2023-24.
Message displayed
Multiple business validations failed.
What does it mean?
Your payment request has more than one claim validation rule that has failed.
What should you do?
Check that you have entered all the payment request details correctly.
Complete the following checklist:
- Check if you are recorded as a my provider for NDIA-managed participants.
- Check if the budget still has funding available to support your claim.
- Check if the dates you are claiming for fit within the correct plan.
- Make sure your claim aligns with the pricing arrangements and limits.
Once you have completed all checks, make the required changes to the original file, rename the file, save the file and upload the corrected bulk upload file.
Further information on bulk payment rejection reasons can be found in the Bulk Payment request self-help guide by visiting the myplace provider portal and resources page.
Providers should raise claim and payment enquiries through the my NDIS provider portal. A dedicated claims and payment team will action these queries.
Please call the National Contact Centre on 1300 311 675 for further support or discuss claim details further with the participant you are supporting.