Pragmatic AI

Industries / NDIS providers

More supports delivered. Same billing team.

A finished shift or therapy session is not yet a clean invoice. The roster, progress note, service agreement, support item and funding type still have to agree. Mitch and our Central Coast engineers sit with your delivery and billing teams, learn where charges stall, then put AI to work on the routine checks and chasing. Your people confirm delivery and decide disputes.

Where your team's week goes.

  1. Agree and book the support

    Check the participant's funding type, plan dates and service agreement. Put the therapy session, community access visit or SIL support on the roster with the right worker and location.

  2. Record what happened

    The clinician or support worker records the session or shift, including time, travel and what support was delivered. A roster shows the booking; the log or case note explains the work.

  3. Turn delivery into billable lines

    Compare attended time and notes with the agreement. Choose the support item and claim type, then check the price schedule that applied on the service date, including travel or cancellation conditions.

  4. Send it to the right payer

    Invoice the plan manager or self-managed participant. For NDIA-managed funding, prepare the payment request and bulk upload through the myplace provider portal for PACE plans.

  5. Work the exceptions

    A missing note goes back to the worker. A disputed duration goes to the coordinator. A plan manager's query or rejected payment request goes to the billing lead with the roster, note and invoice line together.

  6. Reconcile and follow up

    Match remittances to invoice or claim lines, correct rejected lines, and follow up unpaid invoices without asking the same worker to explain the same shift twice.

The cases that eat the time.

Most of the work goes smoothly. These are the ones that come back to someone's desk, and they're where a case engine earns its keep.

  • A shift with no usable note

    The roster says community access happened on Tuesday, but the case note does not say what support was provided.

  • Hours that do not line up

    The worker's log records 90 minutes; the invoice line says two hours.

  • The wrong payer

    A plan-managed session is queued for an NDIA bulk upload instead of an invoice to the plan manager.

  • Travel that needs checking

    A provider travel line appears beside a home visit, but the agreed travel terms and trip record are missing.

  • A cancellation without the trail

    A short-notice cancellation is billed, but nobody can find when the participant gave notice or which agreement term applies.

  • A price change across dates

    A July support line carries the earlier schedule's rate, so the date of service and current schedule need checking.

  • A rejected bulk claim

    One line in a myplace bulk payment request comes back rejected while the rest of the batch moves on.

  • The SIL item change

    A weekly SIL support delivered after 1 July 2026 is still coded 01_821_0115_1_1 rather than 01_821_0138_1_1.

What stays with your people.

The records and checks help your team act; they do not decide what care happened or settle a participant's concern.

  • What support was delivered

    The clinician or support worker confirms the actual session or shift and writes the clinical or support record. AI can flag a gap between that record and the roster, but cannot fill it in as fact.

  • What to bill when it is disputed

    Your coordinator or finance lead resolves a challenged duration, item, travel charge or rejected claim with the worker, participant or plan manager before correcting or releasing it.

  • The participant's choices and safety

    Changes to agreed supports, complaints and concerns about safety go to the people responsible for the participant relationship and the support. They are not treated as billing tidy-up.

What we'd measure together.

Before anything is built, we measure how your cases move today. Every change is measured against that, on your own cases.

  • Delivered to billed

    Time from a completed shift or session to an invoice or payment request ready for your team's review.

  • Lines that need rework

    The share sent back for a missing note, mismatched hours, wrong item or payer before billing.

  • Minutes per exception

    Staff time spent finding the roster, note, agreement and earlier correspondence for each disputed line.

  • Rejections and corrections

    Bulk claim rejections, plan manager queries and corrected invoices, tracked by reason and service date.

Works alongside what you already use

  • ShiftCare
  • SupportAbility
  • Xero
  • myplace provider portal
  • my NDIS provider portal

Questions NDIS providers ask us.

☛We already use ShiftCare. What would you add?+

Keep the roster, notes and invoices there. We start with the cases that still make your team open several records: a changed shift, an unsupported travel line, a plan manager query or a rejected claim. We map the exact handoff and check what access your existing systems actually allow before proposing a build.

☛Can it tell us what to claim for a shift?+

It can compare the roster, worker record, service agreement and current support catalogue, then prepare a line or flag a mismatch. The worker or clinician confirms what happened. Your billing lead decides a disputed item or amount; the engine does not invent a note to make a claim fit.

☛What happens to participant notes and NDIS numbers?+

The free first session needs no participant records. If we test a workflow, we agree in writing which fields are needed, who can see them, which systems process them, and when they are removed. We can start with synthetic or de-identified examples where that is useful; we do not put participant notes into a public AI chat tool.

☛Will it send bulk claims or chase plan managers for us?+

We would agree those permissions case by case. A first workflow can prepare the myplace bulk payment request and draft a follow-up with the invoice line and delivery evidence. Your staff review and release claims, corrections and messages, especially when the charge is contested.

☛Where do we start if our billing backlog is a mix of support types?+

Start with a free 30-minute session. Bring one recurring queue, such as community access invoices with missing notes or SIL claims affected by the July item change. We map how that work moves, who resolves the exceptions, and what a small test would have to prove.

Find out how much of your caseload could run itself.

Start with a free 30-minute session. We'll learn how your cases arrive and tell you honestly how much could run on its own, and what that could mean for your growth.