Lumary DC - This article explains how to identify and fix NDIS claim errors.
Once you upload your NDIS claim results file, the Extract Items list shows the PRODA Claim Status for each extract item. Items with an error have a red highlight and PRODA Claim Status of Claim Error. You can manage your claim errors from the extract record to make sure you don't miss out on claiming for services delivered.
Click here to find out how to get to an extract record
- Go to the Lumary Extracts tab.
If you can't see this tab, you may need to check under the More drop-down list or click on the App Launcher nine dot grid and search for enquiries.
- Set Extract Type to NDIS.
- Set the date range to include the date of your extract.
- Scroll down to the Previous Extracts section and look for the relevant extract file.
- Click on the Extract ID text link to open your extract.
When you open your extract record, the NDIS Claim Process Tracker will show you where you're up to in the claiming process. You should be at step 4. Results Uploaded.
This video shows the process:
To manage errors in an extract:
-
Click on the Manage Claim Errors tab.
The tab only appears if the extract you're viewing has unresolved errors. If this tab is not available, refresh the screen and check your PRODA claim statuses to see if any are listed with a status of Claim Error.When it appears, the list includes unresolved errors from all extracts. You may need to take care to make sure you address errors related to your current extract.
- The Status Message column shows the error message from the NDIA.
- The following details the errors you may receive from the NDIA:
| Error Message | NDIS Rejection Code | Suggested Solution |
|---|---|---|
| A payment request can only be submitted until 90 days from the service booking end date. | C09 | Submit claims up to 90 days post the service booking end date. After this period, payment requests may not be paid and you will need to contact NDIA. |
| ABN must be provided in the claim. | V21 | When claiming against plan managed service bookings a valid ABN of the support provider must be provided. If you are making a claim against a standard service booking, leave the field blank. |
| Cancellation reason is mandatory for Cancellation claim type | C30 | A valid cancellation reason when submitting a short notice cancelation: NSDH: No show due to health reason / NSDF: No show due to family issues / NSDT: No show due to unavailability of transport / NSDO: Other |
| Claim amount must be greater than 0.00. | C20 | Check Service Delivered Record and Extract Item and ensure the quantity and unit price result in a positive claim value greater than $0.00. |
| Claim can't be processed. There are multiple fields which need checking. Please check all information and resubmit or contact us. | MB1 | Review all claim fields for accuracy (dates, amounts, participant details, support item, GST code). Check each field against the error messages. If problems persist, contact NDIA on 1800 800 110. |
| Claim exceeds the allowed time for submission | C39 | Claims must be submitted within 2 years of the support start date. For exceptional circumstances beyond 2 years, submit a payment enquiry with supporting evidence. |
| Claim Invoice number is missing. | C12 | Review the extract item to ensure there is a valid claim reference number |
| Claim is outside the plan dates | C28 | Ensure Service Delivered start/end dates fall within the participant's active plan period. |
| Claim must be submitted within 2 years of the support start date | C39 | Submit claims within 2 years of service delivery. Claims older than 2 years may be considered under exceptional circumstances—submit a payment enquiry with supporting evidence. |
| Claim rejected after review by NDIS. | V20 | Contact NDIA directly on 1800 800 110 for specific rejection reasons and next steps. |
| Claimed item is quote item. It cannot be claimed until quote is received. | C26 | Ensure the quote has been submitted to and approved by NDIA before claiming for this support item. Check quotation status in myplace portal. |
| Claims can not be made for a future date. | C27 | Service delivery dates must be today or in the past (already delivered). Check and correct the date of service. |
| Error occurred when creating claim. Check all details in the claim and then resubmit or contact NDIS for help. | S02 | Review all claim details (participant ID, support item, dates, amounts, GST code). If error persists, contact NDIA on 1800 800 110. |
| GST code selected is incorrect. | M06 | Review Extract Item and ensure the correct GST code: P1 (10% GST), P2 (GST Free), or P5 (GST Out of Scope) per NDIS guidelines. |
| Incorrect participant, service booking or provider selected. | M04 | Verify the NDIS number (9 digits starting with '43'), check the service booking exists, and ensure you're the correct registered provider. May need to create new service booking with correct details. |
| Insufficient evidence or authorisation provided. | M03 | Upload the correct documentation required to complete the payment request. This may include service agreements, quotes, tax invoices, or participant authorisation. |
| Input quantity is more than the available service booking quantity. | C04 | Review Service Delivered record and reduce the claim quantity to match or be less than the approved service booking quantity. Check the service booking details and create a new booking if further funding needed. |
| Maximum allowed claims for given Claim Reference Number reached. | P05 | You cannot claim for the same claim reference number more than twice. Review the extract item and ensure you use a new unique reference number or verify you haven't been paid twice. |
| NDIS reviewed and rejected claim as participant disputed receiving support. | V19 | Contact NDIA directly. Provide evidence of service delivery (attendance records, service notes, signed documentation). Confirm you have a valid 'My Provider' relationship. |
| No active bank account details recorded. Please review the bank account details. | C14 | Add or update your bank account details in Profile > Bank Details before submitting claims. Enter Account Name (max 40 characters, letters only), BSB (6 digits), and Account Number (up to 12 digits). |
| No approved service booking exist for the selected product within the selected start/end dates. | C05 | Verify a service booking/service agreement exists for this support item during the claimed service period. If plan has expired, contact NDIA for assistance. |
| No plan found for participant within the start and end dates. | C22 | Ensure the participant has an active NDIS plan covering the service delivery dates. Verify plan dates with participant. Create service booking within correct plan period. |
| No service booking exist within the selected participant and provider. | C01 | Confirm a service booking exists between you and the participant. Create a service booking within the relevant plan period before submitting payment request. |
| Only registered providers can provide this support. ABN must be provided in the claim. | V21 | When claiming against plan managed service bookings a valid ABN of the support provider must be provided. If you are making a claim against a standard service booking, leave the field blank. |
| Participant does not exist in the selected Service Booking. | C07 | Verify the correct NDIS participant number (9 digits starting with '43'). Check the service booking was created for the correct participant. Individual must be valid participant, not nominee. |
| Payment Request already exists with the same details. | P04 | This is a duplicate claim. Check your claim history to ensure this service hasn't already been claimed. |
| Payment Request Rejected. | A01 | Contact NDIA directly on 1800 800 110 for specific rejection reasons. |
| Payment Request Start and End dates must be within the Registration start and end dates, of the applicable registration groups | C32 | Ensure your provider registration for this support category is active during the service delivery dates. Check registration dates in PRODA or contact NDIS Quality and Safeguards Commission. |
| Payment request could not be successfully submitted due to some reason. Contact customer service centre for further information. | M07 | Contact NDIA directly on 1800 800 110 for specific error details and resolution steps. |
| Payment requests cannot be processed while your account is undergoing a review. | C37 | Wait until NDIA completes the review of your provider account. Contact NDIA on 1800 800 110 for review status and timeline. |
| Please provide Claim Reference Number for Covid-19 related special claims. | C35 | Include the specific COVID-19 Claim Reference Number provided by NDIA when claiming COVID-19 related supports. |
| Please provide a valid service provider ABN number / exemption reason. | C33 | Add your 11-digit ABN to your PRODA profile. If exempt, add valid exemption reason: EXCLS (ATO Excluded Supply) or REIMB (Participant Reimbursement). |
| Price requested for the payment request is not valid within the selected support start and/or end dates. | C17 | Verify you're using the correct NDIS price guide rate applicable for the service delivery dates. Support items have valid start and end dates—check Pricing Arrangements and Price Limits. |
| Price submitted exceeds the limit per the support catalogue | C38 | Reduce the unit price to match the NDIS Support Catalogue price limit for this support item. Check current Pricing Arrangements and Price Limits. |
| Product selected is incorrect. | M02 | Ensure the correct support item/line number from the NDIS Support Catalogue is selected for the service provided. Verify support item is in the correct support category. |
| Provided ABN Number / Exemption reason is not valid | C34 |
When claiming against plan managed service bookings a valid ABN of the support provider must be provided. Ensure that either a valid provider ABN is entered, or a valid ABN exemption reason is recorded before resubmitting - valid exemption reason (EXCLS or REIMB). |
| Provider is not registered for this support item. Please review the claim. | C15 | Ensure your NDIA registration includes the registration group required for this support item. If you're a plan manager, confirm the fund management type. Update registration with NDIS Quality and Safeguards Commission if needed. |
| Quantity entered is more than the approved quantity in the service booking. | C04 | Review Serevice Delivered Record and reduce the claimed quantity to match or be less than the service booking approved quantity. Check plan and create new service booking if needed. |
| Quantity should only be 1 for Covid-19 related special claims. | C36 | Review Service Delivered Record and change the quantity to 1 for COVID-19 special claims as per NDIA guidelines. |
| Requested amount is more than the available service booking amount. | P01 | When an NDIS claim exceeds the available funds in a service booking, you either need to reduce the claim, negotiate a higher booking amount with the participant (if funding allows) via your Plan Manager/Coordinator, or update the service booking in the portal to reflect agreed changes, ensuring it stays within overall plan limits |
| Requested amount is more than the participant budget amount. | P03 | Check the claim amount is correct. Participant may have insufficient funds. Contact participant to advise no support budget available, or contact NDIA if issue persists. |
| Reversal of exceeds the original budget. | R01 | The reversal/cancellation amount cannot exceed the original approved budget. Review and adjust the reversal amount. |
| Reversal of exceeds the service booking amount. | R02 | The reversal/cancellation amount cannot exceed the original service booking amount. Review and adjust accordingly. |
| Reversal of exceeds the total payment request amount. | R03 | The reversal amount cannot exceed the total amount of the original payment request. Check and correct the reversal amount. |
| Selected participant is a self-managed. Only support budget detail is required for such payment request. Product selection is not required. | C19 | For self-managed participants, claim using support budget categories only. Do not select specific support item line numbers. |
| Selected participant is not self-managed. Provide product level details for such payment requests to process. | C18 | This participant is plan-managed or agency-managed. You must select specific support item line numbers from the Support Catalogue, not just support category. |
| Selected product is not relevant for the payment request submitted. | C21 | Select a support item that matches the type of service provided and is appropriate for the claim type (standard, cancellation, etc.). Check service booking for correct support item. |
| Selected quantity or unit price is incorrect. | M05 | Verify on the service delivered record that the quantity matches service delivered (whole numbers or decimal for hours). Check unit price matches NDIS price guide in format 0.00 (dollars and cents without $). |
| Service Booking does not exist. | C01 | Create a service booking/service agreement with the participant within the relevant plan period before submitting claims. |
| Service booking could not be generated as no budget is available in participants plan. | C23 | Participant has insufficient funds in their plan. Contact participant or their nominee to advise no support budget available for the service booking. |
| Service booking could not be generated as no fund-management agreement exists for this participant. | C25 | Participant may be self-managed or have a plan manager. You may need to send a tax invoice directly to the participant or plan manager rather than claiming via myplace. |
| Service booking for the product entered is still awaiting approval. | C02 | Tick the 'Service Booking Declaration' checkbox to approve the service booking, or wait for participant to approve the service booking they created. |
| Service booking generation failed. | C24 | Retry creating the service booking. If error persists, contact NDIA on 1800 800 110 for technical support. |
| Support start and/or end dates are not valid. | M01 | Enter valid dates in DD/MM/YYYY or YYYY-MM-DD format. Ensure start date is before or equal to end date, within plan dates, and not in the future. |
| Support start and/or end dates entered are after the recorded date of death for the participant. | C11 | Verify service delivery dates are before participant's recorded date of death. Services cannot be claimed after death. If services were provided on/after death date, contact NDIA. |
| Support start/end dates entered are outside the service booking dates. | C03 | Ensure claimed service delivery dates fall within the service booking period. Check service agreement dates and create new service booking with correct dates if needed. |
| The NDIS support selected was not funded in the plan when the support was delivered. Please review the support item selected. | V16 | Select a support item that was funded in the participant's plan during the service delivery period. Check plan details with participant or nominee. |
| The claimed support is agency managed for the claim period. | V43 | You cannot claim agency-managed supports directly. NDIA manages payment for agency-managed supports to the provider directly. |
| The claimed support is plan managed for the claim period and the provider does not have the plan manager role. | V33 | Only the designated plan manager can claim plan-managed supports for this period. Submit your invoice to the plan manager instead. Contact participant to arrange payment. |
| The claimed support is self-managed for the claim period and can't be claimed by providers. | V23 | Self-managed supports are claimed by participants, not providers. Send a tax invoice directly to the participant or their nominee. |
| The plan management type for this support category cannot be claimed by the service provider. | V13 | Check the plan management type (self, plan, or agency managed). You may need to invoice the plan manager or participant directly rather than claiming via myplace. |
| The price entered exceeds the price of the product approved in the selected service booking. | C06 | Check the the Rate on the Service delivered record matches or is less than the approved service booking price (Price Guide). |
| The service provider is either not listed under the participant's My Providers for the specific support category, or they are on the list but not for the support dates. | V11 | Ask the participant to add you to their 'My Providers' list in myplace for the relevant support category and date range. Contact participant to discuss provider arrangement. |
| The support is not available for the dates entered. Please review and try again. | C16 | Select service delivery dates when this support item was available and funded. Each support item has valid start and end dates—refer to Pricing Arrangements and Price Limits. |
| The support item selected can not be claimed. | V10 | This support item may require special approval or cannot be claimed via standard process. Review Pricing Arrangements and Price Limits, then contact NDIA for guidance. |
| The support start and end dates run across multiple plans. Please review the support dates and ensure claims are separated into a single plan period. | V26 | Split the claim into separate invoices, with each claim falling entirely within a single plan period. Claims cannot span multiple plan periods. |
| The support start and/or end date is missing from the claim. | C10 | Ensure both start date and end date for the service delivery period are in DD/MM/YYYY or YYYY-MM-DD format. |
| The support start date for the claim cannot be after the support end date. | V03 | Review the Service delivered record and ensure start date is before or equal to end date. Check dates are in correct format. |
| The support start or end date falls outside the participant's plan period. Please review the support dates and ensure they are within a single plan period. | V36 | Adjust service delievery dates to fall within the participant's current plan period. Check plan start and end dates. Claims cannot include dates across multiple plan periods. |
| The support was delivered after the participant left the scheme. Please review the support dates. | V46 | Services cannot be claimed after participant exits NDIS. Verify participant status and service dates. Submit a payment enquiry if support was delivered after participant exited. |
| The unit price claimed is above the NDIS price limit. | V31 | Check the the Rate on the Service delivered record and ensure the unit price is equal to or below the maximum allowed in the NDIS Support Catalogue Pricing Arrangements and Price Limits for this support item. |
| There are insufficient funds in the funding period for the NDIS support. Please review the claim. | V27, V28 | Participant has insufficient budget in the funding period (stated or flexible funds). Check claim amount and contact participant/plan manager about available funds. |
| There are insufficient funds. Please review the claim. | V17, V18 | Reduce claim amount or check with participant/plan manager about available budget in relevant support category (stated or flexible funds). |
| This claim has been identified as a duplicate. Please review the claim history. | V04 | Check claim history to confirm this service hasn't already been claimed, paid, or is pending payment. If not a duplicate but details match, submit payment enquiry with supporting invoices. |
| This service provider is not recorded as the Plan Manager for the support period. The support selected cannot be claimed by this service provider. | V15 | Only the registered plan manager can claim this support for this period. If you are the plan manager, ensure your registration is current. Visit My providers | NDIS for information. |
| This service provider is not recorded as the Support Coordinator or Recovery Coach for the support period. The support selected cannot be claimed by this service provider. | V14 | Only registered Support Coordinators or Recovery Coaches can claim these supports. Verify your registration type and role details are correct, or contact NDIA. |
| This support item is not allowed for this claim type selection. | C29 | Review the Service Delivered Record and/or Extract Item and ensure the appropriate claim type matches the support item: blank/Direct Service, CANC (cancellation), REPW (report), TRAN (travel), NF2F (non-face-to-face), THLT (telehealth), or IRSS (irregular SIL). |
| Unit of measure is missing for the selected product. | C13 | Review the Service Delivered Record and/or Extract Item and ensure the correct unit of measure for the support item (hour, each, week, kilometre, etc.) from the dropdown or ensure it's specified in bulk upload. |
| We couldn't find a plan that matches the NDIS number you provided. Check the NDIS number and resubmit with the correct NDIS number for the participant. | S01 | Verify the 9-digit NDIS participant number starting with '43' is correct. You may have entered parent/nominee number instead. Check with participant for their correct NDIS number. |
- To make adjustments to an SD record, go to the Serviced Delivered column and click on the record's text link. You may need to go to other parts of the system to fix the issue with your SD record.
-
Once you've reviewed your SD record and made any required changes, go back to your extract. If you're still on the SD record, you can:
- Scroll down to the Extracts section
- Click on the EXT text link in the Current NDIS Extract Item field
- Scroll down to the Details section, and
- Click on the EXT text link in the Extract field.
- Click on the Manage Claim Errors tab.
- Click on the pencil icon in the Error Fix Status column and select an option from the drop-down list. The purpose and outcome of each option is described in the table below.
If you fixed the issue and plan to reclaim the service delivered, select Fixed to be Reclaimed. This will unlink the SD record so that it can be included in a new extract.
| Setting | Purpose and outcome |
|---|---|
| Fixed to be Reclaimed |
For SD records that you've fixed so that they can be included in a future extract and claim. This setting will:
These changes allow the SD record to be included in a new extract. |
| Cannot Claim |
For SD records where the error shows that the service delivered is not eligible for claiming from the NDIS. The SD record will not be included in any future extracts. |
| Claimed Manually |
For SD records where the claim with the error was fixed by claiming manually through PRODA from the myplace portal. The SD record will not be included in any future extracts. |
- Once you've added your fix statuses, click on the Save button.
When you refresh your browser, the fixed claims will be removed from your Claim Errors list. Records that you fixed to be reclaimed will be ready for inclusion in a new extract that includes them in the date range.
As well as sending you the results file, the NDIA will provide a remittance file that shows the amount that was paid for each claim item.
If you're using the NDIA Integration Module, you'll receive a remittance notification. In the Extract Items list, the PRODA Claim Status for successful claims will update to PAID.
If you don't have automatic claiming, the last step in the claiming process is to upload the remittance file. This will align your records to your paid NDIS claims.