Free tool
Claims gap calculator
Paid after you deliver care? Work out how much cash is tied up between paying your team and being paid by NDIS, Support at Home, Child Care Subsidy, Medicare, PBS or insurers.
Cash tied up at any time
$0
With your growth
$0
Check my options →Planning estimate only. No credit check to enquire.
Why care businesses need this number
Most health and care businesses pay their people before they're paid themselves. An NDIS provider pays support workers for shifts that are claimed afterwards. A home care provider under Support at Home claims after each service is delivered. A childcare centre is paid subsidy after its session reports are submitted, which the Family Assistance Guide says must happen within 14 days after the end of the week of care. A GP practice in the Bulk Billing Practice Incentive Program receives its incentive quarterly. The cash that sits in that gap is real money the business has spent and not yet recovered.
When the business is steady, the gap is steady. When it grows, the gap grows with it, often faster than owners expect. That's why busy, profitable care businesses can still find payroll week stressful.
How the calculator works
It adds up three delays and subtracts one:
- Claim lag. If you claim weekly, a service waits on average about half a week before it's claimed.
- Payment lag. The days from submitting a claim to cleared funds.
- Rejections. The share of claims that need fixing, multiplied by the extra days they take.
- Less your pay cycle. Staff are paid after they work, so on average you hold about half a pay period of wages.
The total gap in days, multiplied by your daily cost of delivering services, is the cash tied up at any time. The growth figure adds the same calculation for the new clients you're taking on.
How to shrink the gap before you borrow
The cheapest working capital is the kind you don't need. Claim more often, get claim data right the first time, follow up slow plan managers and insurers, and keep session reports and visit notes current. Our pages on NDIS payment delays, Support at Home cash flow and Child Care Subsidy cash flow give sector-specific tips. If the gap is still bigger than your reserves comfortably cover, a line of credit is built for exactly this pattern.
See what could cover your gap
Enquiring takes about 60 seconds and there's no credit check when you first ask. We don't pass your details to a queue of lenders. A real person who understands payment cycles in care businesses will call you. Please enter accurate figures on the form so we can match you properly first time. Start your enquiry, or plan a bigger project with the fit-out and equipment calculator.
Frequently asked questions
What is a claims gap?
It's the cash your business has already spent delivering care, mostly on wages, that hasn't yet come back as payment. It builds up when you're paid after delivering a service, as NDIS, Support at Home, Child Care Subsidy and many insurer arrangements work.
How accurate is the result?
It's a planning estimate based on averages you enter. Real claims arrive unevenly, so your lowest bank balance can be lower than the average suggests. Use it to size a buffer, then check it against a month-by-month cash flow forecast.
What payment times should I use?
Use your own history where you have it. Official guidance helps for some payers: the NDIA says valid claims from recorded 'my providers' are usually paid within 2 to 3 business days and others can take about 10 business days, Services Australia says pharmacies using online PBS claiming are paid each week, and the Bulk Billing Practice Incentive Program pays its incentive quarterly.
Why does my pay cycle reduce the gap?
Because staff are paid after they work. If you pay fortnightly, on average you've had the benefit of about a week of work before paying for it. The calculator subtracts that from the gap.
Can finance cover the claims gap?
Yes. A line of credit or short-term unsecured facility, typically $5,000 to $500,000 for trading businesses and sized on turnover and bank statements, is commonly used. There's no credit check when you first enquire.
Keep payroll safe while claims catch up
A line of credit sized on your turnover can bridge the claims gap. One short enquiry, no credit check, and a real person calls you back.
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