quickclaim and VisiCase Care Management System partner to empower ndis care providers
April 15, 2024
VIDEO: An update on PACE – how quickclaim is helping service providers with the transition
April 24, 2024
The National Disability Insurance Scheme (NDIS) has been a transformative force in Australia, aiming to provide support and services to people with disabilities. As part of its ongoing evolution, the NDIS has recently announced a significant change in its payment processes: the transition to pre-payment claim reviews in the PACE system. This shift introduces new procedures for care providers seeking reimbursement for services rendered to NDIS participants.
Under the previous system, NDIS checks were carried out to ensure accuracy of payments. With an extra layer of validation and consent, the NDIS is now looking to clamp down on fraud, possibly delaying payments up to 10 days, versus next day payments.
The move to pre-payment claim reviews means that some claims will undergo review and validation by the NDIS before payments are authorised. This new approach allows the NDIS to assess the validity of claims, reducing the likelihood of errors or discrepancies.
With an extra layer of validation and consent, the NDIS is now looking to clamp down on fraud, possibly delaying payments up to 10 days, versus next day payments.
New review procedures from the NDIS
If the NDIS decide to review a claim, they will send the provider an email that:
- notifies that the claim has been placed on hold
- requests further information
- provide a fact sheet with instructions on how to identify the status of held claims
Pre-payment claim reviews can help prevent fraud and misuse of funds within the NDIS system. By scrutinising claims before payments are made, the NDIS can identify and address any irregularities or inaccuracies promptly. This proactive approach enhances the integrity of the scheme and reinforces trust among participants, providers, and the broader community.
However, the transition to pre-payment claim reviews also presents challenges and adjustments for care providers. Providers must adapt their administrative processes to comply with the new requirements, including timely submission of claims and ensuring accuracy and completeness of documentation. Additionally, providers may experience initial delays or complications as they familiarise themselves with the new system.
Furthermore, some providers may face increased administrative burdens associated with pre-payment claim reviews, particularly if they lack the necessary resources or expertise to navigate the process efficiently. It is essential for the NDIS to provide adequate support and guidance to assist providers during this transition period, minimising disruptions to service delivery and ensuring the smooth implementation of the new payment framework.
Providers must adapt their administrative processes to comply with the new requirements, including timely submission of claims and ensuring accuracy and completeness of documentation.
In conclusion, the transition to pre-payment claim reviews represents a significant change in the way care providers interact with the NDIS payment system. While this shift offers potential benefits such as improved cash flow and enhanced fraud prevention, it also poses challenges that must be addressed to support providers effectively. By collaborating with providers and offering necessary support and guidance, the NDIS can successfully implement pre-payment claim reviews and continue its mission of empowering people with disabilities to achieve their goals and participate fully in society.
How quickclaim can help
Stay on top of changes to your NDIS billing and claims with quickclaim. All claims in review and on hold are displayed in the quickclaim interface - so you know at a glance the status of any payment.
