The Apoio Pulse – Issue 59 - Manual Claim Process

We hope this message finds you well! We’re reaching out to share some important insights about the Manual Claim process within the NDIS. We understand that navigating this aspect can be a bit tricky, so we're here to help clarify things in a straightforward, friendly manner.

What is the Manual Claim Process?

A manual claim is essential when the automated claiming options are off the table, typically due to exhausted plan funds. This usually happens when a participant has fully utilised their allocated funds and the plan's end date has passed. At this stage, plan managers can step in to submit any outstanding invoices manually to the NDIS payments team for processing.

How Does It Work?

The manual claim process begins with the collection of all outstanding invoices that need attention. These are then submitted directly to the NDIS payments team, stepping outside the regular automated systems. It's a critical step, especially when automatic claims aren't possible, to ensure that service providers are considered for compensation.

Why Is It Required?

This process is indispensable mainly because it provides an alternative pathway to seek funds when the usual routes are no longer viable. However, it's crucial to understand that approval isn't automatic. Each invoice undergoes a thorough review to determine eligibility for payment based on the funds already spent and the terms of the NDIS plan.

What Happens Next?

Upon submission, two outcomes are possible: approval or denial of the claim. If approved, funds are disbursed as per the usual process. If denied, it’s important for participants, their representatives, or their support coordinators to explore alternative funding sources. This could mean tapping into government programs, charitable organisations, or community resources to ensure continued support and services.

We hope this breakdown helps you understand the manual claim process better and prepares you for any situation that might require its use. Should you have any more questions or need further assistance, don't hesitate to reach out.