Support at Home claiming problems send shocks through sector

Eight months into Support at Home, and unresolved issues with claiming are having significant impacts on providers and vendors alike.

Home care providers continue to experience problems putting claims through Services Australia, putting significant pressure on cash flows.

But the onus to fix the issues is falling not on Services Australia or the Department of Health, Disability, and Ageing, but on the providers themselves and software vendors.

A spokesperson for Silverchain, one of Australia's top five largest home care providers, told The Weekly SOURCE there are "significant challenges" with billing and claiming under Support at Home. 

"At present, the system is more complex than it needs to be," they said.

"Providers are required to submit highly detailed, technical claims that don’t reflect how care is actually delivered, creating unnecessary administrative burden and diverting resources away from clients."  

Further complicating matters are "inconsistencies" caused by "unclear requirements around evidence for claims" and "variation in how rules are interpreted".  

System functionality, testing environments and payment processes are all causing "delays and requiring additional effort" from providers to resolve, they said.  

The challenges are impacting cash flow, increasing costs, and risk slowing access to care, the spokesperson said. 

Silverchain says it is working with Services Australia and the Department of Health, Disability and Ageing to resolve the issues.

"Puts doubt into the system"

Kaylie Clarke, Manager with Queensland home care provider Mullein Care, confirmed to The Weekly SOURCE the new claims process through Services Australia is "slower, time consuming and not efficient". 

Complicating matters is the fact there is no direct phone number to call for support. When calls are made to a central support services, they are often directed to an alternative number or the new number is not in service.

The provider has been left trying to resolve situations they don't fully understand, all the time also trying to keep their customers informed.

It's a financial and reputational risk and "puts doubt into the system", Kaylie said.

The process is also costly and labour-intensive.

Ross Gallagher, CEO of Illawarra-based provider IRT, told The Weekly SOURCE that invoicing is so complex, their organisation has put on seven staff members just for the task of data entry alone.

Training falls to vendors

While providers are left scrambling, resolving the problems also often falls to software vendors.

Caroline Lee, CEO of Leecare, said their customers are experiencing problems with claims as rules around submissions were incomplete, with very limited technical specifications to enable software to address these.

With providers in the dark, it often falls on LeeCare to train providers on how the new system should be working.

The result is a system that is adding to costs, straining cash flow and pulling staff away from care.