SIL Billing Audit for NDIS Providers

Why SIL Billing Is Different

SIL supports are delivered in settings with multiple participants, rotating staff ratios, overlapping shift boundaries, and continuous 24 hour coverage. Every one of those factors creates a claim accuracy risk. A single misrostered overnight active shift can cost a provider hundreds of dollars per week for months before it is caught.

Where SIL Revenue Goes Missing

Ratio Misclaims

A 1:2 SIL support is claimed at 1:1. A 1:3 support is claimed at 1:2. Sometimes the direction is reversed and the provider overclaims, which creates compliance risk. Ratio accuracy requires shift level tracking of which staff member covered which participant at which time.

Active Night vs Sleepover

Active Overnight and Sleepover Overnight are different line items at different rates. Providers sometimes claim Sleepover rates for shifts where the staff member was actually active, or vice versa. The correct claim depends on documented activity during the shift, not on the scheduled category.

Shift Overlap Errors

When one staff member's shift ends and another's begins, the overlap window can be double claimed or missed entirely. SIL providers with changeover windows at non standard times are particularly exposed.

Time Band Mismatches

A SIL shift that crosses the weekday evening boundary at 8pm must be split in the claim so each portion carries the correct rate. Providers claiming the whole shift at the lower rate undercharge. Providers claiming the whole shift at the higher rate create compliance risk.

Public Holiday Shifts Missed

Public holiday loading on a SIL shift is materially higher than weekend rate. State specific public holidays are the most commonly missed. A SIL provider running Christmas and Easter periods at standard weekend rates will leave significant revenue uncollected.

Irregular SIL Add Ons

Certain situation specific line items (for example, Higher Intensity Daily Activities supports within a SIL arrangement) require careful line item selection. Providers frequently default to the wrong item and leave money on the table.

Our SIL Audit Process

We audit your last 12 months of SIL claims at the shift level, not the summary level. Each shift is cross referenced against the roster, the staff clock in data, the progress notes, and the participant's service agreement.

Findings are grouped by error type and quantified in dollars. We tell you exactly which shifts need re billing, which need correcting, and which rostering rules need to change so the errors stop recurring.

What You Get

• A written findings report listing every recoverable SIL claim with the dollar value
• A rostering rule change list so the errors stop returning
• If engaged, full recovery claim preparation and submission
• Staff training on the specific SIL claim rules your team is getting wrong

What It Costs

The initial audit is free. You only pay if we find recoverable revenue and you choose to proceed. Pricing is either success based (percentage of recovered revenue) or a fixed weekly advisory retainer for ongoing support.

Related Services

If you want a wider audit across all categories, see NDIS Revenue Audit. For a general overview of the errors we catch, see Common NDIS Billing Errors.