Providers flag “millions” in unpaid Support at Home claims as admin burden bites

Home care providers are reporting significant delays in Support at Home claims and manual adjustments, with some warning they are carrying unpaid invoices worth tens of thousands of dollars – and that sector-wide outstanding amounts now total “millions of dollars.”

Ageing Australia CEO Tom Symondson told The Weekly SOURCE the peak body is aware of providers waiting on outstanding payments and is working with both the Department of Health, Disability and Ageing and Services Australia to triage cases where delays are creating cashflow stress.

“Providers are waiting on outstanding claims to be paid, totalling millions of dollars,” Tom said.

Tom said both agencies had been responsive when providers raised cashflow concerns.

“The Department and Services Australia have been very responsive to providers experiencing cashflow issues,” he said. “Our priority is to ensure continuity of care for older people and timely payment to providers for the services they deliver.”

Services Australia disputes claims of unpaid claims

Services Australia, however, said claims volumes and outstanding numbers do not support the suggestion of widespread unpaid claims.

In a statement attributed to Services Australia General Manager Hank Jongen, the agency said:

“Most Support at Home claims are processed by Services Australia within two days and there are no outstanding claims submitted by providers in November and December 2025.”

“As at 27 January 2026 there were only 80 Support at Home claims which had been submitted but not yet approved,” Mr Jongen said, noting the figure is a point-in-time number that changes daily.

Services Australia said it cannot calculate the total value of unpaid claims until processing occurs.

Between 1 November 2025 and 27 January 2026, Services Australia said 5,077 Support at Home claims were submitted.

Providers describe a different reality

A home care provider, who requested anonymity, told The SOURCE they were carrying close to $60,000 in unpaid amounts linked to manual adjustments and rejected claims – including Assistive Technology and Home Modifications (AT-HM) related items – with no clear timeframe for resolution.

“I’ve got nearly $60,000 sitting there with no clear timeline of when that’s going to get paid,” the provider said. “I’ve had to pay that money out to providers who have delivered these services.”

The provider rejected the idea that the system was only dealing with a small number of delayed items, arguing that manual adjustments – and the workload created by fixing and resubmitting rejected items – were not being captured in the numbers.

“They’ve had to put on a whole team to process [manual claims]… if you’ve put on a whole team to process, you’ve got more than 80,” the provider said.

“From half an hour to one-and-a-half days”

Beyond payment delays, Tom said members continue to raise concerns about the administrative burden of claiming under Support at Home – even when systems are functioning.

“There are significant manual processes to successfully claim, creating an administrative burden, even when systems are working properly,” he said.

He said providers report the time required to lodge a claim has increased dramatically.

“We have heard reports that the time it takes to lodge a claim has increased from half an hour to as much as one and a half days,” Tom stated. “Some providers have been forced to hire additional staff to manage the workload.”

Providers also report that claim complexity has changed from submitting a monthly total to line-item level claiming, particularly for high-frequency services such as transport – increasing the number of transactions required per client each month.

See the payments process flow diagram from the Support at Home program claims and payments business rules guidance released last November below.

Push to streamline system design

Tom said Ageing Australia is advocating for process fixes and system redesign, including options such as bulk upload.

“We’re regularly meeting with the Department, Services Australia, and the Commission to work through these problems,” he said. “There are some issues which appear to require simple fixes, but there are many more that will take months to smooth out.”

“We have identified some of the system design and processes causing this significant administrative burden. We are also offering solutions, like enabling bulk upload of data,” he said.

Tom added that the peak body recently advocated for changes to the Aged Care Rules to allow advanced payments to Support at Home providers where payment issues arise due to new systems.

The stakes: continuity of care

The claims dispute lands at a challenging time for the home care sector, with providers balancing higher administrative overheads, tighter compliance expectations, and the financial reality that unpaid claims can immediately impact on cashflows.

Tom said the peak body’s focus remains keeping services running while the system stabilises.

“The introduction of efficient processes is one of our highest priorities,” he said.