How We Ensure NDIS Compliance Without Gatekeeping Your Funds

Gatekeeping of funds refers to when a provider, at times a plan manager, is stopping a participant from using their funds effectively.

While NDSP may flag an invoice if it is not suitable for sending to the National Disability Insurance Scheme (NDIS), we do not do this out of any motivation to control how your funds are spent. We do this to bring up any issues and resolve them ahead of time, so that any invoices submitted to the NDIS are accurate and compliant.

In this article, we will go over what the role of a plan manager is, and how NDSP fulfils this role to ensure you are getting the most out of your NDIS plan.

 

Why your plan manager should never ‘gatekeep’ your NDIS Funds

The role of a plan manager does not extend to determining whether supports or services purchased are ‘reasonable and necessary’. Plan management simply acts as a financial intermediary between yourself and the agency.

As a participant, your individualised plan funding serves to cover the reasonable and necessary supports specific to helping you achieve your goals – these are approved by the National Disability Insurance Agency (NDIA) at the planning stage.

There is no need, or right, for a plan manager to further restrict this funding.

What a plan manager should do is make sure that your plan is being implemented as intended; that funds are being allocated and used in line with the expected NDIS plan spend. 

If your use of funds is not compliant with your plan, you run the risk of:

1. invoice rejection from the NDIS; or
2. having to pay the NDIS back for misused funds.

 

Unsure about whether your funds are being used appropriately? We have a general guide regarding what your NDIS funding can be used for.

 

Why do my invoices sometimes get rejected?

The NDIS has cracked down on misappropriation of funding, which means it is more important than ever that your invoices be correct and your funds utilised as per your plan.

NDSP’s role in this process is to ensure any invoices submitted are compliant. Our expert knowledge of NDIS funding allows us to provide expert guidance in this area. We run our own checks before your invoice is submitted to the NDIS, so we can catch any potential issues before they become a problem, such as:

1. The service or product does not align with your NDIS plan.
2. The cost of the service does not comply with the NDIS Pricing Arrangements (previously known as NDIS Price Guide).
3. Administrative error – provider or participant has incorrect or incomplete details.

 

The purpose of NDSP running our own checks in-house is to find any of these discrepancies before the invoice goes to the NDIA. This can save you a lot of back and forth with the NDIA itself, which risks increasing the time between submitting the invoice and funds being released.

If your invoice is rejected by NDSP on the grounds of non-compliance, we will provide a reason why and explain, where possible, what you need to do in order to make the invoice compliant. 

This might be an administrative error to fix. Or, we may recommend a plan reassessment if your goals or support needs seem to be shifting beyond what your current plan covers.

Invoicing best practice: A checklist for participant providers

Administrative errors on invoices are usually because the details required to submit the invoice are not filled out properly. All invoices need to include:

• Client’s full name and their NDIS number
• Unique invoice number
• Dates of services provided
• Quantity, duration of the services provided
• Brief description of the service/s
• Hourly or unit rate
• Total amount due
• Service Provider’s ABN number
• Service Provider’s payment details

 

In the interests of getting payments processed quickly, we recommend providers become familiar with the above. Invoices can be easily submitted to us through invoices@ndsp.com.au with the client’s email in the CC field.

 

3 warning signs to watch out for with plan management specialists

Finding an organisation you can trust to manage your NDIS funding can feel daunting, and there are plenty of horror stories online. Thankfully, you can switch plan managers to a more suitable provider should you see any of the following behaviour:

1. Your plan manager only accepts certain provider invoices

Your plan manager might recommend service providers to you, but they should not be dictating who you can and cannot use. The advantage of plan management over agency management is that you have control over which providers you use (as long as their service costs are in compliance with the NDIS pricing guidelines).

2. They tell you not to contact the NDIA

While your plan manager will do the legwork between you and the NDIA for invoicing, record keeping, and other financial administration, they should not be blocking or discouraging you from contacting the NDIA if you have concerns.

3. There are some ‘additional’ charges for plan management

Plan management is fully funded by the NDIS upon participant request. There should be no out-of-pocket cost to you, nor any pulling from funding earmarked for other supports.

Your Plan Manager has a legal responsibility to ensure your NDIS funds are spent in accordance with your plans. This means enabling you to use these funds:

1. Where supports are described generally and you have flexibility in implementation. For example, core supports can be used more flexibly to help you in day-to-day life.
2. Where supports are not flexible (stated supports) and must be purchased according to specifics of your plan.

 

This responsibility does not extend to limiting your choice of providers, or the use of flexible budgets. So long as services/purchases comply with NDIS standards and your participant plan, there is no reason for your plan manager to object.

See more: NDIS Funding Categories Explained

NDSP protects your funds without gatekeeping

NDSP is committed to ensuring compliance without gatekeeping your funds. In practice, this looks like a focus on transparency, accessibility and personalised service. 

• You will always be able to access a real-time view over expenditures, budget tracking, and the status of your invoices through our 24/7 online Nappa Portal.
• All our participant clients receive a monthly summary report in addition to this access.
• We provide support and expert advice on plan utilisation through our nationwide network, helping you make the most out of your budget.
• You can also call  us on 1800 63 63 77 to personally query any of these details, or get fast answers for other questions you may have about how we are managing your plan.

 

Our team are experts regarding the NDIS. We know the ins and outs, the jargon, the fine print – and we have resources available if you would like to brush up your knowledge on this as well, including our free online Participant Toolbox.

We also help Support Coordinators to gain a fuller understanding of NDIS compliance, so they can better support their clients.

If you are a participant or provider looking for quality, comprehensive services in plan management, contact NDSP today to find out more about how we can help you.