The Challenge
Valley Support Services had a recurring nightmare: PRODA claim rejections. Every fortnight, the billing coordinator would spend two full days preparing claims in a spreadsheet, uploading them to the NDIA portal, and then spending another day correcting rejections caused by mismatched service codes, incorrect dates, or support amounts that exceeded plan budgets.
“We were losing money we had already earned,” says director Aaron K. “One quarter we had over $18,000 in delayed payments because of claim errors. The money came eventually, but the cash flow pressure was real.”
The Switch to Maxpilot
Valley implemented Maxpilot primarily to solve the billing problem. The platform’s built-in PRODA integration pulls shift data directly from the roster, cross-checks it against each participant’s plan budget and registered support items, and flags any issues before submission.
The first billing cycle after going live, Valley submitted 340 claims. 334 were approved on first submission — a 98.2% approval rate, up from a historical average of around 81%.
The system caught three errors before we even submitted. Old me would have submitted those and been chasing corrections for a week. Maxpilot just flagged them and told me exactly what to fix.
Time Saved
The billing cycle that used to consume five working days now takes less than four hours. The coordinator still reviews claims before submission, but the manual data entry and cross-referencing has been eliminated entirely. Shift records created by support workers flow automatically into the billing module.
Broader Impact
With billing under control, Valley’s leadership team now uses Maxpilot’s reporting to track plan utilisation across the participant portfolio — identifying participants who are under-utilising their plans and proactively reaching out to increase service hours. This has contributed to a 14% increase in revenue per participant over six months.