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.
The full workflow, from trigger to completion.
Automation is triggered when a participant's service period end date is reached and billable hours are recorded.
The automation queries the NDIS portal and internal participant database to retrieve current plan status, remaining balance, and service approvals.
Timesheets, invoices, and declarations are automatically gathered, email, and connected systems and consolidated into a single package.
An intelligent reviews the claim amount against the participant's remaining plan balance and service approvals, flagging any discrepancies for human review.
The claim package is automatically formatted to match the specific funder's requirements and requirements are validated.
The formatted claim is automatically submitted to the correct funder portal using API integration or secure upload.
A claim record is automatically created with the submission date, funder, amount, and expected payment date.
Finance staff receive a summary email confirming the claim submission, funder, amount, and next review date.
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