NDIS claims and remittance · NC-006

Common rejection reasons and how to fix them

Each rejected claim line arrives in the rework queue with the NDIA’s reason and a suggested fix. This article lists the common reasons and what to do about each.

Before you begin

  • Results have been imported for a batch.
  • Permission to correct rework lines (Finance role).

Open the rework queue

  1. Go to Billing → Rejected lines.
  2. Filter by Reason or Status (Open, Waiting, Corrected, Queued, Written off, Redirected).
  3. Read each line’s NDIA reason, the check that would have caught it, and the Suggested fix.
  4. The Why open lines were rejected chart shows the most common reasons.

Fix by reason

  1. Price exceeds price limit or Price exceeds the unregistered provider limit: select Correct and set the unit price to the limit on the service date (the drawer shows it).
  2. Support item not in plan budget or Claim type not valid for the support item: select Correct and choose a support item funded in the plan.
  3. Service date outside plan dates or No service booking or provider endorsement: check the date, or mark the line waiting (clock icon) until the new plan or booking is in place.
  4. Insufficient funds in the plan budget or Support is not agency managed: talk to the participant or coordinator, then use the redirect icon to Bill another payer.
  5. Duplicate claim: if the support was already paid, select Write off.
  6. Participant NDIS number not found: fix the NDIS number on the participant’s record, then correct and re-claim.

Record your team’s know-how

  1. Under a suggested fix, select Add team note.
  2. Write how your team fixes this reason in How your team fixes it and select Save note. It shows on every line rejected for that reason.

Tips

  • Most rejections are caught before upload by the pre-submission checks. Re-run them on the next batch.
  • Where Axis AI suggests a fix, a person must Approve or Reject it.

If something goes wrong

Correct isn’t offered on a line.

Only fully rejected lines can be corrected. Part-paid lines can be written off or redirected.

A write-off went to approval.

Write-offs above your organisation’s threshold go to Home → Approvals inbox first.

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