Using the Claim management module in quickclaim

This module is where you can claim, edit, create and manage errors in all agency-managed claims... no more spreadsheets!

The Claims Management menu is organised into several tabs:

1. Ready to Claim
2. Claim Recovery
3. Successful Claims
4. Claim Batch History
5. Claims in Error
6. Remittance

Ready to claim

This is where you can review all agency-managed claims that have been pushed through from the “Service delivery” module.

• You can record a manual claim, edit or reject a claim using the buttons under the “action” column on the right hand side. 
• You can see the total number and value of the claims up the top of the screen. 

• You can filter to see specific participants, times, or products. 
• Claiming them pushes them directly into PRODA. You’ll be able to see whether they were successful within an hour of clicking on the Claim” “button. 

Claim Recovery

This is where claims go that have not been approved through PRODA. They have had some kind of problem. This module allows you to assess the problem, fix it, and either re-claim or reject it. 

1. 1. 1. You will see in the screenshot below that the “error” column tells you why the claim has not been approved. For example, 

• Product selected is not valid within the selected support start and/or end dates. This means you need to fix the Service Booking dates. 

1. Service Booking does not exist. This means you need to go back to the Service Booking module and add a Service Booking. 
2. Requested amount is more than the available service booking amount. This means you need to edit the amount you claimed or amend the relevant service booking. 

• Multiple business validations failed. Resubmit it with correct information or contact customer service centre to get additional information. 

1. You can make any notes in the “notes” column about actions you’ve taken. If quickclaim is connected to your CRM, it will sync those notes there too. 
2. Once you’ve made the relevant changes, you can re-claim using the blue buttons in the right hand corner. 

Successful claims

This module shows you all claims that have been successful. PRODA takes about 20 minutes to process, and quickclaim updates each hour. You should see all successful claims within an hour. 

You can use the “x” button under the Actions column on the right hand side to cancel a claim. The following will pop-up, asking you for the reason for cancelling the claim, and prompting you to adjust it in your finance software as well. 

 

CAP payments in NDIS

This concept, introduced by the NDIS, occurs when they accept a payment request (so they will end up in Successful Claims) but pay a lesser amount than claimed.

To reconcile capped payments, you can:

1. View the successful page, which includes both the claimed amount and the paid amount.
2. Check the claim batch history. In the claim batch details, a CAP flag set to "YES" indicates that the NDIS has capped the payment.
3. Review the remittance page, where the NDIS specifies the amount paid for all transactions along with the PRN number.

Claims in error

This module shows you all claims that have resulted in errors. 

1. 1. In the example below, you can see that these claims should have been invoiced to plan managers instead of pushed through as agency-managed claims. 
   2. Note in the Transaction ID column there is are two numbers: a series of five, then a single number. The five-digit number keeps track of that claim, while single number refers to the number of times a claim has been reclaimed. This means no claim can be re-claimed multiple times causing multiple errors. 

1. Claim batch history. Each time you claim a group of claims, it gets lodged as a “batch” in quickclaim and also in your finance software. This module allows you to view the detail of each batch, download it as a CSV file (using the icons under the Actions column on the right hand side)

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