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I’ve heard there’s a new mandatory deadline for how long after a service is delivered it can be claimed. Is this correct? Sometimes our payments slip through the cracks and we only find out several months after we’ve delivered the support that we haven’t billed for it.
This is a timely question, as there have been a few changes to this recently.
First, to answer your question clearly: yes, the NDIA has introduced a formal time limit. In the updated legislation, effective from 3 October 2024, a new requirement was introduced that all claims needed to be made within two years of the service being delivered. Note that there is no minimum time frame - as long as you can evidence that the claim was made after the support formally concluded, then a provider can claim immediately.
This rule applies to all providers, Plan Managers and Self Managers. It is listed under section 45A of the updated Act.
A 12-month grace period was in place from when the legislation came into effect on 3 October 2024 to 3 October 2025. It applied to supports delivered before the new law was enacted. This was to acknowledge that the new rule was dropped on providers without significant notice.
At midnight on 2 October 2025, the grace period will end. If a claim is made more than two years after the service is delivered, the NDIA will automatically reject it.
The main reason for this change relates to fraud detection and prevention. The NDIA’s data shows that a significant number of fraudulent claims are made from old Plans. Very old claims are harder for everyone to verify, as they are more likely to be missing documentation or the person may not be able to remember when and how the support was delivered. I can’t remember what I had for breakfast today, much less the details of a service I received many months ago.
Regardless, I would say it’s always a good idea to have the smallest amount of time possible between service delivery and claiming. Most providers are now moving to claiming more frequently (fortnightly, weekly, daily, even live or close-to-live billing) compared to the common industry standard in the early days of Scheme rollout of billing monthly. This has the advantage of allowing providers to avoid the cashflow headache of having already paid workers but not yet having claimed, by helping close the gap between when you’ve paid your workers and when the NDIA or Plan Manager pays you.
Human error happens, of course. Many providers have a bad debt percentage baked into their organisational budget that includes claims that slip through the cracks. That’s why the timeline from the NDIA is so long (at two years). But it’s a good idea to conduct regular self-audits of your rostering and claiming systems to make sure you’ve submitted claims for all the eligible services you’ve delivered.
