How-to

Submitting a claim

Review and submit a Ready claim to the provider.

Most claims submit themselves. AIR encounter claims flow through automatically when a vaccination encounter is completed. PPA and state-funded claims (CVCP, NIPVIP, QLD Free Flu, NSW Free Intranasal, and others) submit automatically once the site is enrolled in the program — they reach Ready and the program's submission processor takes them from there. The manual submission flow below applies to claims you submit yourself, either because the program isn't auto-submitted or because a Ready claim needs attention before it goes out.

If a Ready claim isn't being picked up automatically, the most common reason is that the site isn't enrolled in the program — see Enrolling in a program.

Steps

  1. Open the Claims page

    Filter or search for the claim, or tap the Ready status card to see every claim waiting for submission.

  2. Open the Submit sheet

    Tap the paper-plane icon on the claim row. The Submit PPA Claim sheet opens.

  3. Review the prepared claim

    Every field is pre-filled from the encounter — patient Medicare, vaccinator AHPRA, vaccine brand, batch, date of service, and so on. You can't edit from this sheet — if something's wrong, close the sheet and amend the underlying encounter first.

  4. Check warnings

    If the prepared claim has warnings, they appear near the top of the sheet. Common warnings flag special Medicare circumstances or missing optional data that isn't required but is worth noting.

  5. Acknowledge the declaration

    Every claim requires a declaration — tick the checkbox confirming that:

    • The information is accurate
    • The patient meets eligibility criteria
    • You've met the program's record-keeping requirements
    • You understand the privacy and audit obligations

    The declaration text varies by program (NIPVIP's is longer than MedsCheck's). Read it — it's the legal representation Light makes to the provider.

  6. Submit

    Tap Submit Claim. The claim moves to Submitted immediately. The provider processes it asynchronously — status transitions to Accepted or Rejected when they reply, usually within minutes.

If the Submit button is disabled

  • Declaration not ticked — acknowledge it to enable Submit.
  • Status isn't Ready — only Ready claims submit. If it's Pending, wait. If Rejected or Failed, amend first.
  • Missing data — if critical fields didn't populate from the encounter, the claim stays in Pending until the data's available. Amend the encounter to fill the gap.

After submission

Submitted claims appear in the Submitted status card. When the provider responds, they move to Accepted or Rejected.

Rejections include an error message from the provider — see Amending a rejected claim.

Automated submission for enrolled programs

For programs that are submitted automatically (most PPA programs once the site is enrolled, plus state programs like QLD Free Flu), you don't need to follow the steps above for every claim. Light takes the claim through Ready → Pending → Submitted on the program's cadence:

  • The claim reaches Ready as soon as evaluation succeeds.
  • The submission processor moves it to Pending when it picks the claim up for the next batch — locking it into that batch.
  • After the batch is sent (and the funder has accepted the payload), the claim moves to Submitted.

The cadence depends on the program:

  • Per-event programs (NIPVIP, CVCP) — Ready → Pending → Submitted in seconds.
  • Cadenced programs (QLD Free Flu, NSW Free Intranasal) — Ready claims wait until the program's submission day. On the day, eligible Ready claims move to Pending together and are invoiced as a single batch. See Setting up QLD Free Flu claiming for the QLD invoicing cycle.

Automated submission still respects the per-claim safeguards: an Ineligible claim won't be picked up, and a Removed claim is terminal. You can also amend or remove a Ready claim before it's picked up for a batch — once it's Pending it's locked into the batch and submission is imminent.