NDIS to Move to Real-Time Claims

NDIS

The National Disability Insurance Agency (NDIA) is planning to overhaul its payment system through the development and implementation of a real-time claims and direct payment solution. As payment volumes continue to rise, the NDIA hopes that the new system will enable participants and providers to lodge claims automatically, expediting the claims process.

Reasons for the change

There are currently around 365,000 active participants in the scheme, with payments for 2018-19 totalling approximately $10.2 billion. Over the next five years, it is estimated that more than $22 billion will be paid out through the scheme to 500,000 Australians with disability each year, putting a strain on the system and increasing the need for a faster and more efficient claims system.

Currently, claims are lodged by either the participant, provider, or the NDIS after a service has been carried out, through either the myplace Participant or myplace Provider online portals. The NDIA said that in some instances a .csv file is then uploaded to the NDIS portal, providing details of a number of claims. This is a slow and antiquated process that results in lengthy delays between the provision of support, and payments are prone to error.

To fix this outdated process, the NDIA aims to develop a solution that enables providers and participants to automatically lodge claims, known as payment requests, in real-time and at the point of support. The agency expects that moving from the current portal-based manual claim processing to real-time claims at the point of sale will result in significant benefits for participants, providers, and the NDIA.

Benefits of a real-time claim system

It is anticipated that providing one simple, consistent, automated claims and payments process between the provider and the NDIA will increase efficiency through automatic calculations, reduce the financial burden on participants and providers, and improve customer experience. The NDIA will also benefit through increased transactional data visibility and strengthened fraud controls, improved payment correctness, and reduced overheads associated with manual processing.

NDIS provides its participants with the support and services they need to achieve their goals, but the claims process can be complicated and difficult to navigate. While the move to real-time payments should make the process simpler, it may take some time to get the new system up and running. In the meantime, we are here to help. The team at LiveBig will not only help you get your head around the current claims system but will provide you with ongoing support for years to come.

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