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Achieve Australia — Systems Scoping

Funding / Billing / Claims Feedback Loop

The forward path (deliver → claim → invoice) is well-instrumented. The feedback path — variance identified, routed, resolved, reflected back — is only evidenced for a narrow set of known error types. Broader reconciliation is confirmed as not happening as at June 2026.

Loop health
Partially closes at best
Reconciliation step ownership: "Role TBC"
Pending-status revenue
$1.2M
Revenue Review, 6 Nov–4 Dec 2024
Accounts receivable
$4M
Invoices up to 6 months late
Unmapped process endpoints
6
AR, Finance Reporting, Clearing, Payroll Processing, Accounts Payable, Rejection Handling

Loop diagram

flowchart TD
    A["Funding advised via client/family,\nBusiness Development (HubSpot),\nSupport Coordinator, or Service Manager"] --> B["NDIS Administrator drafts\nStatement of Service (SOS)\nin Visicase"]
    B --> C{"Ops Management\n(SM/GM) agree\nservice detail?"}
    C -- "No — returned for amendment" --> B
    C -- Yes --> D["SOS sent to Plan Nominee\nfor signature (DocuSign)"]
    D --> E["Signed SOS returned"]
    E --> F["NDIS Admin updates Visicase:\nbudget entered, case file\nPENDING → APPROVED"]
    F --> G{"Revenue Accountant\nvalidates Visicase entry\nvs signed SOS"}
    G -- "Variance found" --> F
    G -- Match --> H["Service booking created\nin QuickClaim / PRODA"]

    H --> I["Weekly billing cycle (Tuesdays):\nshift/timesheet approved,\nactivity report run,\nQuickClaim bulk upload"]
    I --> J{"Activity report total\n= QuickClaim upload total?"}
    J -- "No" --> K["Manual investigation &\nreconciliation (undocumented\nas a defined process)"]
    K -.-> I
    J -- Yes --> L["Claims submitted to Agency /\nPlan Manager; invoices\nposted in Business Central"]

    L --> M{"Claim accepted?"}
    M -- "Rejected — known error types\n(service booking missing,\nfunding entity wrong,\ninsufficient funds)" --> N["NDIS Admin / Finance\nresolve and reclaim"]
    N -.-> I
    M -- Accepted --> O["Reconcile Payments\n(03.03.04 To-Be)"]

    O --> P["⚠ GAP: swimlane owner\nis 'Role TBC'; diagram marked\n'OLD MAP - Awaiting Confirmation'"]
    P --> Q["Accounts Receivable —\nNOT MAPPED"]
    P --> R["Finance Reporting —\nNOT MAPPED"]
    P --> S["Clearing Process —\nNOT MAPPED"]
    O --> T["Credit note / dispute path\n(mapped, but Verify/TBC\nintegration steps unresolved)"]

    U["Evidenced leakage points\n(Revenue Review, 6 Nov-4 Dec 2024):\n$1.2M pending-status revenue ·\n$4M AR, invoices up to 6mo late ·\n$5k/month from unapproved timesheets ·\n1,100 open claim errors (~4 hrs/week to fix) ·\nLedger↔sub-ledger reconciliation\nnot being performed"] -.->|"evidence"| O
    V["CEO Report 25 Jun 2026:\nConnect payroll bug 15 Jun,\nmanual workaround required"] -.->|"corroborates ongoing fragility"| I
    W["Sustainability Report 25 Jun 2026:\nSOS still only exists as a\nnon-searchable PDF; Visicase\nbudget field 'still being updated'\npost-Connect"] -.->|"same gap, ~19 months later"| F

    classDef gap fill:#f4dad7,stroke:#b3352f,stroke-width:2px;
    classDef evidence fill:#ece3d3,stroke:#7a6e5e,stroke-width:1px;
    class P,Q,R,S gap;
    class U,V,W evidence;
Designed process step Gap — unmapped / undefined ownership Independent corroborating evidence

Stage-by-stage narrative

1–2. Funding notification → draft SOS → sign-off

The NDIS Administrator drafts the Statement of Service from a separate SOS spreadsheet quote (based on the prior year) and a "Roster of Care" tool — not directly in Visicase. Ops Management validate the draft; once signed by the Plan Nominee via DocuSign, Visicase is updated within 2 business days (budget entered, case file PENDING → APPROVED). As of the Nov–Dec 2024 review this DocuSign/upload step "can sometimes be forgotten," and pending-status revenue outstanding was $1.2M.

Funding Procedure.pdf §4.4–4.6Revenue Project Process Maps Released.pdf

3. Validation loop — one of the few that genuinely closes

The Revenue Accountant independently validates Visicase entry against the signed SOS; any variance is returned to the NDIS Administrator for correction within 1 business day. Two related but distinct Control Points exist separately in Governance (§7): CP1 (active client list vs open case files) and CP2 (the weekly "Traffic Light" claim-vs-budget report).

Funding Procedure.pdf §4.8, §7

4–5. Weekly billing → claim submission → invoicing

Billing runs weekly (Tuesdays): shift/timesheet approval, an activity report from Visicase, a QuickClaim bulk upload, and a manual cross-check that totals match — no system enforces this. Successful claims invoice via Business Central; rejected claims land on a "claim recovery" tab with defined error categories. As at the 2024 review, 1,100 claims had open issues, taking an estimated 4 hours/week to resolve.

Funding Procedure.pdf §5.1–5.1003.03.01–03 (To-Be)

6. Reconciliation — where the loop breaks

03.03.04 Reconcile Payments (To-Be) is the step that should close the loop. In the source process map, the entire swimlane is labelled "Role TBC", with a handwritten annotation: "OLD MAP – Awaiting Confirmation." Six downstream endpoints are explicitly marked "(not mapped)." The 2024 review independently confirms this is real: "Reconciliation is not currently being done between: Ledger–BC, Sub-ledger–Visicase."

03.03.04 Reconcile Payments (To-Be)Revenue Project Process Maps Released.pdf, p.2

7. Persistence into 2026

Two board papers from the same 25 June 2026 meeting show this isn't historical. The Sustainability Report states the SOS "is currently only available in a PDF format (therefore not searchable)" and that post-Connect, the extracted budget field "is still being updated" — the same manual re-keying problem, ~19 months later, post-migration. The CEO's report separately notes a payroll bug 13 days after Connect's go-live requiring a manual workaround.

5.4 Sustainability Reporting 1.pdf, Part 2 §36.1 CEO Report.pdf

Where it breaks down

Biggest structural gap
Undefined ownership at the reconciliation step. "Role TBC" on the Reconcile Payments swimlane means, as designed, nobody owns closing the loop between invoice and payment — and six process endpoints downstream of it are explicitly unmapped.

Confirmed, quantified leakage

None of the documents reviewed confirm whether these figures have since improved — see Missing Information.

Structural weaknesses

Missing information

Sources used

Funding Procedure.pdf Revenue Project Process Maps Released.pdf 03.03.01 Client Billing_Claims Setup (To-Be).pdf 03.03.02 Shift Booking Execution (To-Be).pdf 03.03.03 Claims and Client Invoicing (To-Be).pdf 03.03.04 Reconcile Payments (To-Be).pdf 03.03.05 Contractor Payment (To-Be).pdf Achieve_Revenue Project Info Pack.pptx Funding Procedure Overview.pptx 6.1 CEO Report.pdf (Connect rollout / payroll bug section only) 5.4 Sustainability Reporting 1.pdf