Funding & Plan Claims Management

Q: Does the automation handle different funder submission formats?

Yes. The automation reformats documents to match each funder's specific requirements automatically, eliminating manual retyping and formatting errors.

Q: Will existing claim records in the accounting system be affected?

No. The automation creates new claim records going forward and does not modify historical data.

Q: How does the automation know which funder portal to submit to?

The automation identifies the funder based on the participant's funding source in the eligibility data and routes the claim to the correct portal automatically.

Q: What happens if a claim is rejected by the funder?

The automation detects the rejection and sends an alert to finance staff with the funder's reason code. Staff can review, correct, and resubmit without manual portal navigation.

Keep disability support funding claims accurate, reconciled, and submitted without the manual chase work.

272 hrs

Manual time identified

Companies have mapped

Map This Automation

About This Automation

Funding and plan claims management involves verifying participant eligibility, gathering supporting documents, and submitting claims to multiple funders each month.

Automation retrieves eligibility data, collects and reformats documents automatically, and submits claims to the correct funder portal with tracking. Finance staff focus on exceptions and approvals instead of manual data entry and portal navigation.

Key features:

Validate participant eligibility and plan balance automatically against funder systems

Collect timesheets and invoices from email and spreadsheets and reformat for each funder's requirements

Submit claims to the correct funder portal and record submission details in accounting software

Monitor claim status and alert staff to approvals, rejections, or delays

Reduce claim preparation time from hours to minutes per submission

Data insights How it works Apps used What you get FAQ

Top friction points when done manually

The issues teams report most often with this process

#	Friction point	Companies Report This
1	Multiple funder portals Staff must log into separate portals for each funder, each with different submission requirements and interfaces.	80%
2	Document gathering delays Timesheets and invoices are scattered across email, shared drives, and systems, requiring manual searches and compilation.	67%
3	Manual data reformatting Documents must be reformatted or retyped to match each funder's specific submission format and requirements.	53%
4	Claim status uncertainty Staff must periodically check portals and email for approval or rejection notifications with no proactive alerts.	40%
5	Eligibility verification bottleneck Manual cross-checking of plan balances against claim amounts is time-consuming and error-prone.	26%

Disclaimer

Automation readiness

How well-suited this process is for automation

Process Pain Score™

9.2/ 10

AI Fit Rating™

8.7/ 10

Automation Lift Index™

8.5/ 10

Hidden Overhead™

7.3/ 10

How The Automation Works

The full workflow, from trigger to completion.

1. Service Period Closestrigger

Automation is triggered when a participant's service period end date is reached and billable hours are recorded.

2. Fetch Eligibility & Plan Data

The automation queries the NDIS portal and internal participant database to retrieve current plan status, remaining balance, and service approvals.

3. Collect Supporting Documents

Timesheets, invoices, and declarations are automatically gathered, email, and connected systems and consolidated into a single package.

4. Validate Claim Eligibility

An intelligent reviews the claim amount against the participant's remaining plan balance and service approvals, flagging any discrepancies for human review.

5. Format & Prepare Claim

The claim package is automatically formatted to match the specific funder's requirements and requirements are validated.

6. Submit to Funder Portal

The formatted claim is automatically submitted to the correct funder portal using API integration or secure upload.

7. Record

A claim record is automatically created with the submission date, funder, amount, and expected payment date.

8. Send Confirmation to Finance

Finance staff receive a summary email confirming the claim submission, funder, amount, and next review date.

Most popular tool stack used

— the complete tool combinations companies use

52% of companies

28% of companies

15% of companies

Disclaimer

What you get when you map this process

Everything you need to understand, plan, and build your automation.

ROI and business case

What this process costs today and what changes once it's automated.

Launch schedule

What gets built, in what order, and what success looks like once it's live.

Process runbook

How the automation runs day to day, including exceptions and human decision points.

Developer handover pack

Full build spec, logic, and configuration — ready to hand off without a briefing call.

Integration and connections guide

Every tool connection, credential, and data mapping the build needs.

Test and QA plan

100 hrsIdentified

4Mapped

View

Frequently asked questions

Everything you need to know before mapping this process.

What happens if a participant's plan balance is insufficient for the claim amount?

The automation flags the eligibility issue and alerts finance staff for manual review before submission. Staff can adjust the claim amount or contact the participant to resolve the shortfall.

Does the automation handle different funder submission formats?

Will existing claim records in the accounting system be affected?

How does the automation know which funder portal to submit to?

What happens if a claim is rejected by the funder?

View more FAQs

Process pain:9.2/10

Mapped by:4 Companies

Map this to your business to get your exact numbers.

Map This Automation

No credit card required. It's free.

Page updated 10 August 2026