Claim an Invoice

Learn how to Claim via the NDIS when your Funding Type is Agency Managed in Maica

How do I Claim an Invoice via the NDIS on Maica?

Maica has Automation for NDIS Claiming. This article talks about scenarios in which manual claiming may be required or chosen for a specific Invoice, this process is called Reclaiming.

To learn more about Maica's Claiming Automation, click here.

Claiming only applies when the Funding Type is Agency Managed.

Reclaiming

Unfortunately, not all claiming attempts are successful. There are scenarios within Maica's Claiming Automation in which a Payment Request may be rejected by the NDIS, for example, if the Service Date was to be outside of the Active Service Booking it will result in the NDIS rejecting your claim. Additionally, you also may receive a Failed Payment Request, indicating that the claim was not properly submitted to the NDIS for processing. In these scenarios, the Payment Request status will be updated to either Rejected or Failed and you may need to Reclaim, as shown below.

Maica will provide you with a detailed description as to why your Claim may have either Failed or been Rejected, it is important to address these reasons before Reclaiming.

How do I submit a Reclaim?

In order to manually claim or reclaim an Invoice in Maica, simply navigate to the Invoice record from the Maica menu bar. Once you are in the Invoice record, click the Claim button in the top right corner of your interface, as shown below.

You can also Reclaim numerous Invoices at once if necessary. To do so, pick them in the Invoice list view from the Invoices tab in the Maica menu, and then click the Claim Management icon in the upper right corner of the interface. Follow the same steps outlined below.

Once the Claim button has been clicked, Maica will present a Claim Management screen. This screen will display all the key Invoice information, as well as all Applicable Invoice Line Items. As shown below.

Applicable Invoice Line Items are defined by a set of rules within Maica. These are described in more detail below.

Claim Management Field Description
  1. General Fields

This includes basic information on the Invoice including the ID, Date, Participant, etc. It also includes basic information for each Invoice Line Item including Support Category, Support Item, etc.

  1. Line Total

This is the total sum for the Support Items delivered for each Invoice Line Item.

  1. Claimed Amount

This represents the total amount of money claimed for each Invoice Line Item. If you received a partial payment for a previous claim, this could represent a portion of the Line Total.

  1. Available Claim Amount

This represents the maximum value remaining that can be claimed, and is the difference between the Line Total and Claimed Amount.

  1. Claim Amount

This is a input field that is used to specify the amount you would like to claim during any particular claim attempt. This amount automatically populates to the Available Claim Amount but is manually edited if desired.

Next, confirm all your details are correct by checking the box at the bottom, and submit your Claim.

What happens after I submit my Claim?

After you submit your Claim, the next steps of the process are dependant on your Claim Method settings set by your Organisations Administrator. Your Claim Method will be set as one of the following:

API

If your Claiming Method is API, then there is nothing left for you to do. A new Payment Request will be automatically generated and submitted to PRODA. Your Invoice Line Item will be set to a status of Claimed, your new Payment Request will be set to a status of Awaiting Approval and your Invoice Claim Behaviour will be set to Claim Attempted.

BPR File

If your Claiming Method is BPR File, then, similar to API, a new Payment Request will automatically be generated, however, it will not be submitted for claiming. The Payment Request will be generated and picked up up via the standard BPR File Generation Process.

Once the BPR File is generated (with the newly created Payment Request included), your Invoice Line Item will be set to a status of Claimed, your new Payment Request will be set to a status of Awaiting Approval and your Invoice Claim Behaviour will be set to Claim Attempted.

Applicable Invoice Line Item Rules

Applicable Invoice Line Items in Maica are determined by a set of rules and logic that are important to maintaining the integrity of the software.

In Maica, any Invoice Line Item record that is associated with a Payment Request and holds any of the below listed Status values cannot be Reclaimed. These values include:

  • BLANK

  • Awaiting Approval

  • Pending Payment

  • Fully Paid

Maica considers Payment Request records with the Status values to either be part of an Active or Complete Claim Cycle, and hence we do not allow them to be Reclaimed as to avoid duplicate Payment Requests being generated.

Should you wish to include an Invoice record with such an existing Payment Request, you need to first cancel the Payment Request via the Cancel Quick Action on the Payment Request itself.

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