Plan managers are only able to submit invoices to the NDIA that are a valid claim. Valid claims must meet specific criteria including invoice requirements, NDIS legislation, and meet the supports funded in the participants plan. This document covers some of the considerations for a provider to ensure the claims they submit are valid and meet the NDIA requirements.
As providers of NDIS supports to an NDIS participant, it is your responsibility to ensure the claim is valid. Once a valid claim is received, the plan manager will submit this to the NDIA to be reviewed and payment will be processed once funding is released by the NDIA for the claim.
Valid Claims: A Guide
Submitting Valid Claims to a Plan Manager
As a provider of NDIS supports, it’s the responsibility of NDIS service providers to ensure that invoices are valid and meet NDIA requirements.
Plan managers are only able to submit invoices to the NDIA if they meet the criteria for a valid claim. Submitting correctly the first time helps avoid delays and ensures participants’ funding is used appropriately.
What makes a valid claim?
A valid claim must include certain information to ensure that the claim can be accurately entered.
Invoice Requirements
To be accepted, invoices must clearly show all the essential details about the provider, the participant, and the services delivered. Missing or incorrect information is one of the most common reasons claims are delayed.
- Provider details: name, ABN, contact details, and bank account information
- Participant details: full name, NDIS number, and address
- Service details: invoice number, clear description of supports delivered, service dates, and claim type (e.g. cancellation, NF2F)
- Claim information: number of hours/units, hourly rate, and total amount
NDIS Legislation and Claiming Rules
All claims must follow NDIA’s rules and pricing arrangements. These include limits on certain supports, when they can be claimed, and how they are billed. Staying compliant helps ensure claims are processed smoothly.
- General claiming rules, including time-of-week rules, limits on travel, and NF2F (non-face-to-face) supports
- Only supports approved under the NDIS Pricing Arrangements and limits
- Additional NDIS rules and criteria, including rules for R&N (reporting and non-reportable claims)
Alignment with the Participant’s Plan
Every claim must connect back to the participant’s approved plan. This means the support must be funded, fall within the right budget category, and be delivered within the plan’s timeframe.
- Supports must be funded in the participant’s current plan
- Claims must align with the correct budget, category, and funding period
- Stated supports must only be claimed where they are included in the plan
What happens once a claim is valid?
Once your invoice meets these requirements, the plan manager will submit the claim to the NDIA for review.
Payment will then be processed when the NDIA releases the funding.
By ensuring your invoices meet these standards, you help reduce delays, avoid claim rejections, and ensure participants receive the supports they need without interruption.
P2P has more information available on our website:
- Example Invoice Template (PDF)
- What is a valid claim (PDF – includes a checklist for providers when sending invoices)
- A guide for providers for NDIS invoicing (PDF)