By Luke Benson. Last reviewed 24 September 2026, against the Payment Integrity Rolling Review Cycle 1 summary report and program manual V4.4 sections 10.5, 13.7 and 16.6.
When the Department selects your provider for the payment integrity rolling review, you are notified under section 513 of the Aged Care Act 2024 and given 14 calendar days to upload evidence for around 42 claims and up to five monthly statements. In Cycle 1 the packs ran from about 80 to more than 200 documents. Extensions were offered by exception only. The checklist below is built from what the Cycle 1 reviewers accepted and what they rejected.
1. Pick ten claims from last month at random and pull the delivery record for each. Not the invoice. The record: who delivered the service, what it was, the date and time, and where. If any of the ten takes more than a few minutes, or needs an email to a subcontractor, that is the gap.
2. Check that each record was made at the time. Reviewers rejected care notes written more than a week after the service. A note dated on the day, a clock-in and clock-out pair, or a location-stamped check-in passes. A summary written up at month end does not.
3. Check that each record can be tied to the claim. Reviewers rejected evidence with no date, no description, or no identifier that matched the claim line. The record should name the participant, the service type as claimed, and the date.
4. Know which services an invoice alone will cover. Sections 10.5 and 13.7 of the program manual allow invoice-only evidence for allied health, consumables and meal delivery. Everything else needs a delivery record. Gardening and home maintenance was the worst-evidenced service category in Cycle 1 at 54 per cent, and it is usually subcontracted.
5. Treat subcontracted services as your claims. Under section 11.5 the provider, not the third party, is responsible. Reviewers looked for records that identified the supplier, the service, the date and the amount. Ask now whether you hold those records or the subcontractor does.
6. Check the claim data itself. Reviewers found hours or episodes claimed as a single unit, mismatched dates, and service types miscoded, such as home maintenance claimed as domestic assistance. A delivery record that says 9:00 to 11:00 should match a claim for two hours.
7. Separate the three questions. The review asks whether the service was delivered, whether the price was agreed in advance, and whether the monthly statement was complete. Delivery evidence does not answer the other two. In Cycle 1, 35 per cent of claims evidenced an agreed price and 21 per cent of monthly statements were complete. Those need service agreements with prices, and statement templates checked against the legislative inclusions.
8. Decide who assembles the pack. Fourteen days is short if the evidence lives in five systems and a subcontractor’s inbox. Name the person and the export they will use before the notice arrives.
How DidYouGo fits. DidYouGo covers items 1 to 6 for visit-based services. Each check-in is a dated, location-stamped record of worker, participant and service, made at the door, held by you whether the worker is an employee or a subcontractor, and exportable to CSV or through the API. It does not cover items 7 and 8, which are about pricing, statements and process.
