FOI 24/25-1912 DOCUMENT 16

Complete a desktop review before a check-in

SGP KP Publishing

Exported on 2025-09-17 04:55:26

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SGP KP Publishing – Complete a desktop review before a check-in

1 Recent updates …………………………………………………………………………………………………….. 2 Before you start …………………………………………………………………………………………………….. 3 Complete a desktop review ……………………………………………………………………………………. 3.1 Life stage ……………………………………………………………………………………………………………. 3.2 Participant profile …………………………………………………………………………………………………. 3.3 Disabilities and Impairment categories …………………………………………………………………….. 3.4 Plan duration ………………………………………………………………………………………………………. 3.5 Plan budget and utilisation ……………………………………………………………………………………. 3.6 Consent to share information ………………………………………………………………………………… 3.7 Open and related cases ……………………………………………………………………………………….. 3.8 Complaints ………………………………………………………………………………………………………….. 3.9 Internal reviews …………………………………………………………………………………………………. 3.10 Administrative Review Tribunal (ART) decisions …………………………………………………. 3.11 Plan change requests ……………………………………………………………………………………… 3.12 Reassessment check-ins …………………………………………………………………………………… 4 Review the Person Account ………………………………………………………………………———–– 5 Complete a desktop review for a discretionary overutilisation check-in ……………..–– 6 Next steps ……………………………………………………………………………………………………………

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SGP KP Publishing – Complete a desktop review before a check-in

This article provides guidance for a planner delegate, planner (non-partnered area), review officer, participant support officer, local area coordinator or early childhood partner to:

complete a desktop review
review the Person Account
complete a desktop review for a discretionary overutilisation check-in.

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1 Recent updates

5 May 2025 Guidance updated to:

change the age from younger than 7 to younger than 9 for children who are due to complete Personal and Environmental Circumstances (PEC) questions and functional capacity assessments
check the participant’s current NDIS plan is in SAP CRM or PACE.

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2 Before you start

You have read and understood:

Guide - Conversation style guide
Our Guideline – Your plan (external)
article Understand types of check-ins.

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3 Complete a desktop review

Before a check-in, it’s important to review the participant’s information to understand:

if their current NDIS plan is in SAP CRM or PACE
the reason for the check-in
the participant’s situation
any challenges the participant has with using their plan
how the plan is currently managed
if there is overutilisation or underutilisation of funded supports
if there have been any challenges with accepting claims before
if there are any in-progress or recently closed cases and decision outcomes
any potential changes or updates to the participant’s plan
if the participant is likely to need their eligibility reassessed
any identified risks or vulnerabilities
the participant’s preferred communication method and their personal details, including pronouns
if the participant needs any additional communication support such as an interpreter
evidence from any recent provider reports, including progress reports from support coordinators or recovery coaches.

It’s important to consider if this check-in:

is a regular scheduled check-in
has come from an enquiry
is because the participant’s situation meets the risk criteria
is a discretionary overutilisation check-in
is for the participant transitioning from SAP CRM to PACE
is the last check-in before the participant’s plan reassessment
will be longer because a Short Form Outcomes Framework (SFOF) questionnaire is due
will be longer if Personal and Environmental Circumstances (PEC) questions and functional capacity assessments are due for children younger than 9.

Once you understand the participant’s situation, review their details and any recent interactions.

From the Person Account, select Cases to open and view recent case records.
Select Activity, then select Timeline.
Select Event Type (funnel) on the right-hand side.
Select the checkbox next to Task.
Select Apply.

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Review any past and upcoming cases and tasks.

3.1 Life stage

Check the participant’s date of birth to see if there are any life transitions. A life transition could be if they:

are a child with developmental delay turning 6, or a child with global developmental delay turning 7
are turning 18 or 65
are starting or leaving school
want to start or find a job
want to begin tertiary study, like university or TAFE.

For participants who have a work and study goal in their plan, there are a number of work and study NDIS supports available. For example, there are capacity building employment supports for young people moving from school to work.

To learn more about work and study supports, go to article Understand work and study supports. To learn more about eligibility conversations for children with developmental delay, go to article EC Guide - Check-in eligibility conversations for children younger than 6 with developmental delay.

From the Person Account, select Details.
Check Date of Birth.

3.2 Participant profile

Determine if the participant’s current plan supports them to pursue their goals or if they need new supports.

From the Person Account, select My Profile.
Select Goals to see the participant’s current goals.
Select About Me and ICM Supports (Informal, Community and Mainstream Supports) to learn about the participant’s current supports and involvement with other services.

3.3 Disabilities and Impairment categories

Review the participant’s disability information and impairment categories. Assess new reports or evidence for updated information which show the participant may need a change in supports. For example, support coordination progress reports, therapy reports or an eligibility conversation for children younger than 6 with developmental delay.

To review a disability from the Person Account:

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Select My Profile.
Select Disabilities and Impairment Categories.
Select the Disability record hyperlink to view Details.

To review any new reports or assessments from the Person Account:

Select Documents and review documents.
Select Files and review any further information.

To learn more about impairment categories, go to article View Impairment Categories in the person account.

3.4 Plan duration

For participants transitioning from SAP CRM to PACE, the plan duration for their new plan in PACE will be 12 months. To learn more, go to article Complete a SAP CRM to PACE plan transition.

New participants whose first plan is developed in PACE will have a plan duration of 12 months. The planner delegate will add an internal note if they’ve assessed that plan and recommend a plan longer than the initial 12 months.

To check the plan duration:

From the Person Account, select My Profile.
Select Plan.
Select the hyperlink to view the participant’s current plan.
In Details, check the Next Reassessment Date.

To view any internal communications about the participant’s plan duration:

From the Person Account, select Activity.
Select Timeline.
Select Event Type (funnel) on the right-hand side.
Select the checkbox next to Task.
Select Apply.
Review the list of tasks for Internal Communication.
Select the internal communication and view Details to check any Comments for a plan duration internal note.

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3.5 Plan budget and utilisation

Review information about the participant’s plan to understand how they’re managing their current budget and NDIS funded supports, including fund management options. This is particularly important for a discretionary overutilisation check-in.

Identify if there is overutilisation or underutilisation of funded supports. Check frequent budget updates which could indicate the participant’s plan isn’t meeting their support needs.

From the Person Account, select My Budget.
Budget Overview, Budget Updates, Transactions, Recurring Claims, Bank Accounts, Claim Verification and Claim Reviews will display.
From My Profile, select Plan.
Select the participant’s current plan.
The Plan screen will open.
In Details, check the Plan Management Options.
Select Claims if you want to view recent claims.
Select Related for Plan History and Claim Coverage information.

Confirm the participant has given consent to share information about their plan to providers and approved contacts. You can contact providers and approved contacts if you need more information about the participant’s supports if consent has been provided. You’ll need consent to share information if you refer the participant to new support services. Learn more in article Applicant consent to share information.

From the Person Account, check Cases for open cases that may need action. This may include plan change requests, complaints, pending Administrative Review Tribunal (ART) decisions or internal reviews.

Check any relevant closed cases from the past 18 months, for example previous check-ins or any rejected Plan Change cases.

3.8 Complaints

From the Person Account, select Cases.
Select Feedback & Complaints to check if there are any existing complaints that need actioning.
From the Person Account, select Activity. Review Activity History and Alerts History for any active alerts or open complaints.
Follow up with the complaints officer assigned to an open complaint to see if you can resolve the matter.
If you can’t make contact with the complaints officer, email the complaints team at redacted: s47E(d) - Certain operations of agencies

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3.9 Internal reviews

If there are any outstanding internal reviews which need action:

From the Person Account, select Activity.
Select Activity History and Alerts History to review active alerts or open internal review cases.
Follow-up with the internal review delegate to understand how to proceed with the check-in conversation.

Note: if there’s no internal review delegate assigned, email the internal review team at redacted: s47E(d) - Certain operations of agencies

3.10 Administrative Review Tribunal (ART) decisions

For pending Administrative Review Tribunal (ART) decisions, email redacted: s47E(d) - Certain operations of agencies to learn how to proceed with the check-in.

3.11 Plan change requests

For plan change requests requiring action, contact the my NDIS contact responsible for the case for how to proceed with the Check-in case. Consider if there are any risks to the participant that would mean the plan change request needs internal priority. To review a plan change request, go to article Assign and review a plan change case.

3.12 Reassessment check-ins

If it’s the last check-in before the participant’s plan reassessment, you’ll need to recommend if the participant needs a reassessment or if their plan can be continued. It’s important to review the participant’s current confidence level and compare this with the check-in preparation letter they received 116 days before their reassessment date. This letter tells the participant how to prepare for the upcoming reassessment check-in based on their recommended confidence level. To learn more, go to article Understand types of check-ins.

In some situations, the participant’s confidence level may have changed since they received their letter. This means the check-in purpose and outcomes might be different from that stated in the letter. You’ll need to explain any changes and what to expect before and during the check-in. For example, the participant may have received a letter to say their plan is likely to be continued. Before or during the check-in we decide a plan reassessment is needed and we need to let the participant know to have any new evidence or information ready.

IMPORTANT: we can’t offer a plan continuation to the participant whose plan is moving from SAP CRM to PACE. This is because a new plan must be built to bring the participant’s information across to PACE. When the Plan Transition case is completed and closed, a Plan Approval case will be automatically created with Case Reason: Existing participant – Reassessment due. To learn more, go to article Complete a SAP CRM to PACE plan transition.

To review the participant’s current confidence level:

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From the Person Account, select Cases.
In Open Cases, select the relevant Check-in case from the Case record type.
From the Check-in Case, select Check-In.
View the recommended confidence level at Check-In Preparation.

To review the upcoming check-in letter sent to the participant 116 days before their reassessment due date:

From the Person Account, select Cases.
In Open Cases, select the relevant Check-In case from the Case record type.
From the Check-in case, select Documents.
Select the Upcoming check-in letter.

The recommendation for a plan reassessment or plan continuation can be changed at Potential Risks and Vulnerabilities or the Next Steps of the check-in case.

To learn more, go to articles Record risks and vulnerabilities during a check-in and Complete the next steps during a check-in.

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4 Review the Person Account

Review the Person Account for information which indicates the participant’s situation may have changed.

To review any recent activity:

From the Person Account, select Activity.
Review recent Account Updates for changes to the participant’s details.
Check Alerts History for any active alerts. If appropriate, check SAP CRM for any information that hasn’t moved to PACE.
Review Activity History for any recent interactions.

To review any recent decisions:

From the Person Account, select Decisions.
Review recent decisions to determine changes to the participant’s plan.
Select Decision Name to open for full details.

To review any recent cases:

From the Person Account, select Cases.
Select Request for Services and Critical Incidents to review recorded information.

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5 Complete a desktop review for a discretionary overutilisation check-in

Completing a desktop review for a discretionary overutilisation check-in will help you:

understand how the participant is managing their plan
understand the reason and level of overutilisation
determine what education and support strategies are needed.

This will help you determine if a check-in is needed.

In addition to the guidance in the previous sections of this article, you should consider:

if the participant has been using their funding only on NDIS supports (external) or Replacement supports (external), related to their disability
if the participant has had any supports declined and if there are claims for that support
if there’s any evidence that identifies the reason for overutilisation. This could be in Documents or Activity. For example, the participant is funded for weekday rates and an email from the Support Coordinator outlines that they’re accessing supports on weekends continuously
if there are any unusual requests or patterns in the participant’s payment requests. For example, very large or small amounts or whole numbers like $1000
the risk indicators and support strategies for overutilisation in article Understand overutilisation risk indicators and support strategies.

If another business area is working with the participant, talk to your team leader about how you should proceed.

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6 Next steps

If a Check-in case is automatically created and assigned to you, continue with this Check-in case. Go to article Book change or cancel a check-in.
If it’s a discretionary check-in from an enquiry, you’ll need to create a check-in case. Go to article Create a check-in case.

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