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Learn how to Claim via the NDIS when your Funding Type is Agency Managed in Maica
Please note that this page is a work in progress. The current information about Claiming an Invoice is accurate, but additional content will be added as it is documented. Please check back regularly for updates. If you have any questions or need assistance, feel free to contact our support team here.
There are two ways to claim an Invoice in Maica. These are:
API: Submitting claims directly to the NDIS through an automated, real-time system integrated with the myplace portal using secure authentication.
: Uploading a bulk file of claims to the myplace portal for batch processing, with results manually reviewed from a response file.
In Maica, you can select your Claim Method in the Claim Management Settings. Your Claim Method is usually set by your Organisations Administrator.
To learn more about selecting your Claim Method, click .
Note, claiming only applies when the Funding Type is Agency Managed.
This article details the process of claiming via the API.
To learn how claiming works within Maica if your Claim Method is BPR File, click .
Maica has Automation for NDIS Claiming, meaning as a User, minimal manual input is required. However, the below information details what happens within Maica's Automation if your Claim Method is set to API.
Maica's claiming behaviour is dependant on not only your Claim Method Setting, but also your Claim Behaviour Setting.
To learn more about the different Claim Behaviour Settings, click .
In this article, we will use a Claim Behaviour of Claim Immediately in order to detail the API process. Regardless of your Claim Behaviour, the actual claiming process will be identical to the process detailed below. This is because Maica dynamically updates the Claim Behaviour to Claim Immediately in order to trigger the the callout. For example, if your Claim Behaviour was set to Do Not Claim, meaning you need to use the manual Claim Quick Action, then when used, the Claim Behaviour will be set to Claim Immediately in that moment to run the process outlined below.
Please also note, this section only talks to the Claim process, the Remittance process is further detailed below. The diagram and information below details the process.
For clarity, any Italic text in the description or diagrams refers to an NDIS record, and any standard text refers to a record in Maica.
Claim Executed
First, the Invoice Claim Behaviour (maica_cc__Claim_Behaviour__c) is set to Claim Immediately and a callout is made to the NDIS Payments API.
Retrieve Payment Requests
Create Payment Request
The Payment Request is created via the API
Was the Request Successful?
The logic splits based on whether the Payment Request was successfully created in the NDIS system.
Please note, this step does not determine whether your Claim has been successfully assessed for payment, but rather indicates the Payment Request record has been successfully created in the NDIS system
Update Payment Request (if No)
When No, there are two potential outcomes:
Technical Issue: If the Payment Request record was not successfully saved in the NDIS system, Maica will update the status of the unsuccessful Payment Request to Failed
Claim Issue: The Payment Request was assessed and the claim rejected by the NDIS. An example of this is insufficient budget. In this case, the Rejection Reason provided by the NDIS is returned to the Reject Reason pick list on the Payment Request for your review
Update Payment Request (if Yes)
Process Ends
The claiming process is now complete, and you can wait for the Remittance update to be applied. Note, the Remittance update occurs when the corresponding Notification (Webhook) is triggered by PRODA. The timing of this notification is determined by PRODA, and Maica does not control when it is received. To learn more about the Remittance Notificaiton, see below.
The table below outlines how fields in the NDIS Payments API are mapped to the corresponding fields in Maica's Payment Request object. It shows how data flows between Maica and the NDIS API during Payment Request submissions.
Please note, some fields involve direct mappings (e.g., claimed_amount → Claimed_Amount__c), while others involve calculated values (e.g., quantity → Claimed_Amount__c / Invoice_Line_Item__r.Unit_Price__c).
ref_doc_no
Name
service_agreement
Invoice_Line_Item__r.Booking_Item__r.Service_Booking__r.NDIS_Reference__c
product_category_item
Invoice_Line_Item__r.Support_Item__r.Support_Item_Number__c
participant
Invoice_Line_Item__r.Invoice__r.Participant__r.NDIS_Number__c
claimed_amount
Claimed_Amount__c
quantity
Calculated: Claimed_Amount__c / Invoice_Line_Item__r.Unit_Price__c
tax_code
Invoice_Line_Item__r.GST_Code__c
claim_type
Invoice_Line_Item__r.Claim_Type__c
claim_reason
Invoice_Line_Item__r.Cancellation_Reason__c
start_date
Invoice_Line_Item__r.Service_Date__c
end_date
Invoice_Line_Item__r.Service_Date__c
unit_of_measure
Fixed value: 'EA'
abn_provider
Invoice_Line_Item__r.Invoice__r.Provider__r.ABN__c
abn_not_available
true if Invoice_Line_Item__r.Invoice__r.Provider__r.ABN__c = NULL
This table outlines the response mapping between the NDIS Payments API and Maica's Payment Request object. It shows how key fields returned by the NDIS API are mapped to the corresponding fields in Maica.
claim_number
NDIS_Reference__c
claimed_amount
Claimed_Amount__c
claim_status
The Status value is mapped directly from the NDIS, and could be any of the following:
Failed
Resubmitted (BPR Only)
Incomplete
Awaiting Approval
Pending Payment
Cancelled
Rejected
Paid
Then, Maica retrieves the relevant Payment Request records (field definition ) associated with the Invoice Line Items and sends this to the NDIS to create corresponding records.
Note, when the claiming process is fully automated (via API), all valid Payment Request records are claimed.
The claim is assessed and approved for processing and key Payment Request fields are updated as per the table
Learn about the Invoice Actions within Maica
Invoice actions refer to actions and tasks related to managing and handling your Invoice. There are several actions you can take within an Invoice in Maica, including the following:
This allows you to process payment for a given Invoice, provided Maica's integration with Stripe has been enabled.
This claims the Invoice amount via your configured NDIS claim method.
Reclaiming a Failed or Rejected Invoice manually via the Claim Quick Action
This cancels the Invoice which will exclude it from being claimed.
This allows you to process a credit back to the NDIS via your configured claim method in cases where Invoices have been incorrectly overpaid.
This synchronises the Invoice with the Xero financial system as well as receives any payments that are recorded in Xero against any given Invoice.
The table below provides a summary of Invoice Actions and the applicable Funding Type(s).
Claim
Process Invoice
Email Invoice
Credit
Cancel
Sync with Xero
To dive deeper into each Action, please visit the specific pages for detailed information on every Action.
Learn how to Process Invoices in Maica
In Maica, you can only process payment for an Invoice using the Stripe Payment Integration. Please see below for more detailed information on the steps involved in processing an Invoice using Stripe.
In order to process invoices using the Stripe Payment Integration, you first must have Stripe configured. To learn more about how to configure Stripe in your Maica instance, click here.
The Stripe Payment Integration in Maica allows you to process Invoices directly through Maica using Stripe. In Maica, there are two options for processing an Invoice, these include:
The first choice is handy if your Participant has disclosed a Payment Method and consented to be charged with your organisation, while the second option is useful if they have not.
Please see below for more detailed information on each step in order to process an Invoice.
Firstly, you must begin by setting up Payment Methods for each required Participant(s). The integration allows you to establish a new Payment Method directly from your Participant record. You can begin adding Payment Methods by selecting your Participant record, then clicking the Stripe Payment Methods button, as shown below.
You can add multiple payment methods for each Participant(s). If there are multiple payment methods, you can toggle the default.
After clicking the Stripe Payment Methods button, and before you can add in any Payment Methods, Maica will first prompt you to provide a Stripe Customer ID for the selected Participant(s). If you have one, please enter it in the Stripe Customer ID input in the Participant Record, as shown below.
Alternatively, click the Create a New Stripe Customer button, and Maica will automatically sync with Stripe, create a Stripe Customer ID using the related payment method, and populate this field for you.
Once a Stripe Customer ID has been provided, you will be able to add Payment Methods. The supported Payment Methods are Credit Card and/or Direct Debit.
After Payment Methods have been added, Maica will display the following on the Participant(s) record.
In order to Toggle the Default Payment Method for your Participant(s), simply reselect the Stripe Payment Methods button after a Payment Method has been added. This allows you to choose between any associated Payment Methods, or, a new Payment Method, as shown below.
Simply select which Payment Method you would like to be Default and close the pop-up. Your default Payment Method will be displayed in the Payment Information section of the Participant record, as per the screen above.
Once a Payment Method has been added and the Participant has a Stripe Customer ID, the Payment Method is ready to be charged and hence associated Invoices are ready to be processed.
Invoices can be processed manually or using Maica automation. This article illustrates an Invoice being processed manually. To learn more about Invoice automation, click here.
To begin processing an Invoice, first navigate to the required Invoice then click the Process Invoice button in the top right corner of your interface, as shown below.
Once you click the Process Invoice button, Maica will display a custom UI pop-up, simply select Charge the default payment method associated with the Client. This will charge the Default Payment Method set on the Participant record. This is useful when the payment is coming directly from the Participant.
Once done, Maica will take you to a confirmation page where you can confirm your payment. Once confirmed, the Invoice will automatically update and populate the Stripe Payment Information with a Stripe Invoice ID, Stripe Invoice Link and Stripe Dashboard Link, as shown below.
Your Processed Invoice can be accessed directly from Maica by clicking on the Stripe Dashboard Link or Stripe Invoice Link.
If your Participant has not disclosed a Payment Method with your Organisation or they would rather process an Invoice themselves directly, you can send them a Stripe Hosted Invoice Link for any Invoice they are associated with. This option will provide the URL for the Stripe hosted invoice page, which allows the Invoice Recipient to view and pay the Invoice directly.
Please note, in order to send an Invoice link, you must still have the Stripe Integration Configured.
If your Participant has set up a Payment Method (as above), you can still Process an Invoice through a hosted link if you desire.
You do this by selecting the Process Invoice Quick Action located on the associated Invoice, and selecting Generate the hosted Invoice link.
Once the link has been issued and the Invoice has been processed, a Stripe Customer ID will be populated for the Participant so you can identify them in both Stripe and Maica. Additionally, once processed, the Invoice will automatically update and populate the Stripe Payment Information with a Stripe Invoice ID, Stripe Invoice Link and Stripe Dashboard Link.
Your Processed Invoice can be accessed directly from Maica by clicking on the Stripe Dashboard Link or Stripe Invoice Link.
After your Invoice has been Processed, Maica will generate a payment record. This is the payment that has been used to process the associated Invoice. This record sits within your Invoice record under Payments, as shown below.
The Payment Record holds all the information from the Invoice including Type, Source, Date, Amount , Invoice Number and more.
Learn how to Cancel an Invoice in Maica
In Maica, you can Cancel an Invoice through the Cancel Quick Action found in the dropdown menu located in the top right corner of your interface. Firstly, click the dropdown icon to display the extended Menu options, as shown below.
Then, simply click Cancel.
After doing so, Maica will display a pop-up confirming you wish to Cancel your Invoice. Simply click Confirm to complete the cancellation process. Once done, Maica will replace the Status bar with a cancellation alert, as shown below.
You cannot Cancel an Invoice with a Fully Paid status.
Once you have successfully cancelled your Invoice, three things will automatically occur in Maica, these are:
Maica will set the Status of your Invoice to Cancelled.
The related Field will show Cancelled = TRUE. This is referenced in the Invoice Status Flow.
Invoice History records will be generated reflecting the Date & Time in which the cancellation occurred. These are records accessible directly from the Invoice, as shown below.
Learn how to Sync Invoices with Xero in Maica
Syncing with Xero will only be supported if a Connection and Webhook has already been set up within your Organisation. Before attempting to Sync Invoices, please ensure this is the case. To learn more about configuring your Xero Integration, click here. Syncing with Xero also requires your Support Items to be configured correctly. Please click here to learn how to configure your Support Items in order to facilitate the Xero Integration.
Maica has Automation for Syncing with Xero. This article talks about scenarios in which manual Syncing may be required or chosen for a specific Invoice.
To learn more about Maica's Syncing Automation, click here.
If you wish to manually Sync an Invoice with Xero outside of Maica's automation, the best way to do so is directly from the Invoice Record. Located in the top left corner of the interface, you will a find a Sync with Xero button, as shown below.
Simply click this button to begin the Sync. Once clicked, Maica will display a pop-up confirming that you are about to Sync the Invoice and related Invoice Line Items with Xero. Click Confirm to finalise the Sync.
Once confirmed, Maica will show a success message, and you can shut the window. As shown below.
If you receive an error message at this stage, please ensure your Xero Integration has been configured correctly.
Once done, you will be able to see the Invoice Record in Xero with the matching Invoice Reference from Maica.
To read a full overview of the Xero Integration in Maica, click here.
After an invoice has been successfully synced, the Invoice Record will be updated accordingly. Two new fields will be automatically populated from Xero. These are the Xero Invoice Number and Xero ID, as shown below. These values come from Xero and will help you identify the associated Invoice between Maica and Xero when required.
Learn how to Reclaim via the NDIS when your Funding Type is Agency Managed in Maica
Maica has Automation for NDIS Claiming. This article talks about scenarios in which manual claiming may be required or chosen for a specific , this process is called .
To learn more about Maica's Claiming Automation, click .
Claiming only applies when the Funding Type is Agency Managed.
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.
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. Then, follow the same steps outlined below.
Next, confirm all your details are correct by checking the box at the bottom, and submit your 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:
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.
BLANK
Awaiting Approval
Pending Payment
Fully Paid
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.
In order to manually claim or reclaim an in Maica, simply navigate to the 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.
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 . As shown below.
Applicable Invoice Line Items are defined by a set of rules within Maica. These are described in more detail .
To learn more about Claim Method Settings, click .
If your Claiming Method is API, then there is nothing left for you to do. A new will be automatically generated and submitted to PRODA. Your will be set to a status of , your new will be set to a status of and your Invoice Claim Behaviour will be set to Claim Attempted.
To learn more about the how the API Claim Method works in Maica, click .
If your Claiming Method is BPR File, then, similar to API, a new will automatically be generated, however, it will not be submitted for claiming. The will be generated and picked up up via the standard BPR File Generation Process.
Once the BPR File is generated (with the newly created included), your will be set to a status of , your new will be set to a status of and your Invoice Claim Behaviour will be set to Claim Attempted.
To learn more about the how the BPR File Claim Method works in Maica, click .
In Maica, any record that is associated with a and holds any of the below listed Status values cannot be . These values include:
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 as to avoid duplicate being generated.
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.
Line Total
This is the total sum for the Support Items delivered for each Invoice Line Item.
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.
Available Claim Amount
This represents the maximum value remaining that can be claimed, and is the difference between the Line Total and Claimed Amount.
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.
Learn how to Credit an Invoice in Maica
In the course of processing invoices, errors may occasionally occur, such as submitting a Payment Request with incorrect details, such as the wrong Support Category, Quantity, or Amount. Maica’s Credit Management functionality allows for the easy correction of these discrepancies.
The Credit Management functionality allows you to Cancel a Payment Request that is in the status of Payment Pending or Paid.
As part of this process, it is essential to understand how the NDIS handles a Payment Request once it has been cancelled in PRODA. The following text outlines this:
If you cancel a
Payment Requestwith aStatusof Pending Payment, thePayment Requestwill not be processed.If you cancel a
Payment Requestwith aStatusof Paid, the Agency may:
Send you an invoice requesting repayment of the cancelled amount or
Offset your future payment requests against the cancelled amount
This text is also displayed within the Credit Management tool under NDIS Cancellation Process. It is not unique to Maica and comes from the NDIS, however it has been displayed within Maica for clarity.
This function is only available via the API. If you manage your claiming process via the BPR File, you need to manually Cancel the Payment Request in Maica and PRODA.
In Maica, you can Credit an Invoice through the Credit Quick Action found in the dropdown menu located in the top right corner of your interface, as shown below.
However, in order to be able to Credit an Invoice, two conditions must be met:
Funding Structure = Agency Managed
Status not equal Entered OR Cancelled
If these two conditions are met, you should see the Credit button within the dropdown, as shown below.
You can also Credit 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 Credit Management icon in the upper right corner of the interface. Follow the same steps outlined below.
Once you have clicked the Credit button, you will be presented with the Credit Management pop-up.
The Credit Management tool is divided into two sections.
NDIS Cancellation Process
Selected Invoices
As mentioned above, the NDIS Cancellation Process is shown for clarity. It explains how the NDIS handles a Payment Request once it has been cancelled in PRODA.
The Selected Invoices section displays a list of all Invoices that have been selected to be Credited (if done through the Credit Management option, there may be numerous). Each Invoice will be a dropdown with all the Invoice Line Items and associated Payment Requests that are selectable for Cancellation in order to Credit your Invoice. This is shown below.
From here, simply select the desired Payment Requests you wish to Cancel and click the Credit button in the bottom corner of the interface, as shown below.
The Credit amount is the Sum of all the Paid Amounts from the selected Payment Requests.
After completion, you will notice a green tick next to the Payment Request line, and the Payment Request Status in Maica will be updated to Cancelled.
If the Payment Request had a previous status of Paid, you will either receive an Invoice from the NDIA, or the amount will be offset against a future Payment Request.
