NDIS Provider Registration | Registro
Getting Paid as an NDIS Provider: A Comprehensive Guide
Introduction:
As an NDIS provider, one of the essential aspects of your role is ensuring that you receive timely and accurate payment for the supports and services you provide to participants. Understanding the payment process and requirements is crucial for maintaining a smooth financial operation. In this article, we will explore the various payment methods and guidelines for NDIS providers, along with important considerations to ensure compliance and efficient payment processing.
Self-Managed Participants:
For participants who self-manage their NDIS plan, providers are invoiced directly by the participant, who pays for the services out of their allocated budget. To acquit the expenditure, participants require a receipt from the provider, which is submitted through the myplace participant portal.
Plan-Managed Participants:
When participants have a plan manager assisting them, providers need to send their invoices directly to the plan manager. It is important to include a valid Australian Business Number (ABN) on the invoice, unless the provider is exempt from quoting an ABN. The plan manager will process the payment through the myplace provider portal and handle the payment to the provider.
NDIA-Managed Participants:
For participants who are NDIA-managed, registered providers must submit a payment request through the myplace provider portal to receive payment for the services or supports they have provided. It is crucial to submit the payment request within 90 days from the end of the service booking. The payment request should include specific information such as participant details, support item reference number, dates of support, and support item price.
Prepayment:
In general, prepayment for supports or services is not permitted. However, there are exceptions for certain higher-cost supports where prepayment may be claimed with written approval from the NDIA. Providers should refer to the NDIS Pricing Arrangements and Price Limits for specific circumstances that allow prepayment.
Plan-Managed Payment Requests:
When submitting payment requests for plan-managed participants, plan managers must include a valid ABN unless the payment is a reimbursement to a participant who has paid for a support or service with their own money. This requirement ensures compliance with Australian Taxation Office (ATO) rules regarding ABN quoting. Providers should familiarize themselves with ABN entitlement and exemption guidelines on the ATO website.
In-Kind Supports:
While some providers may receive payment from state or territory governments for certain supports, these types of support are gradually transitioning to the NDIS. Providers should refer to the In-kind supports provider information page for further details and resources regarding in-kind support arrangements.
Invoice Requirements:
To facilitate efficient payment processing, providers should ensure their invoices meet the required standards. Invoices should include the provider’s NDIS business name, ABN, participant’s name and NDIS number, support item reference number, dates of support, total invoice amount, and applicable GST component if applicable. It is important to note that an invoice should only be for one participant but can include multiple supports if applicable. Plan managers must also include the ABN of any third-party provider involved.
Provider Payment Assurance Program:
The Provider Payment Assurance Program aims to verify the accuracy of payment requests submitted by registered providers. To comply with the program, providers must maintain full and accurate records of supports delivered. This includes documenting the participant’s name, reference number (formerly NDIS number), date(s) and total hours or quantity of support delivered, support type, and location of support. Additional documentation may be required depending on the nature of the support.
Retaining Documentation of Support Delivery:
Providers must retain documentation, either electronically or in paper-based form, as evidence of support delivery. This documentation should include the approved service agreement, quotes, evidence of support quantity and type, staff rosters, and final reports or assessments. Logs or rosters for individual support provided and case notes for group
supports are essential for documenting the quantity and type of supports delivered. It is recommended to have these logs or rosters signed by the participant, a parent/guardian, nominee, or carer as confirmation of the support provided.
Depending on the complexity of the support, additional documentation guidelines may apply. Providers should be prepared to provide additional information and case notes as evidence, particularly for more complex supports that require detailed documentation of activities, progress, and plans for future sessions.
Documentation by Support Type:
Different support categories have specific documentation requirements:
Core Supports:
Core supports, including assistance with daily life, transport, consumables, and assistance with social and community participation, are generally episodic. Service agreements, rosters, or logs are typically sufficient to evidence the quantity and type of supports delivered. However, for more complex core supports, a case note or report may also be necessary.
Supported Independent Living (SIL) Supports:
SIL supports, such as assistance in shared or individual living arrangements, short-term accommodation, and assistance from a live-in carer, extend for 24 hours or more. Providers should maintain a formal service agreement that outlines the duration, ratios, costs, and daily supports provided as part of the supported independent living arrangement. Additional documentation should include staff-to-participant ratios, time sheets, group rosters, and case notes detailing activities and skill-building.
Capital Supports:
Capital supports encompass items like continence products, Home Enteral Nutrition (HEN), assistive technology (AT), and vehicle and home modifications. Providers should invoice the participant directly, including the participant’s name, NDIS number, and delivery date. Invoices for capital supports may not require additional documentation of quantity or support type, but it is essential to ensure accurate invoicing.
Capacity Supports:
Capacity supports cover various categories, including support coordination, improved living arrangements, increased social and community participation, finding and keeping a job, improved relationships, improved health and wellbeing, improved learning, improved life choices, and improved daily living. These supports typically require both logs or rosters and case notes to evidence the quantity and type of support provided. In some cases, a final report or assessment may be requested if it is an outcome of the support delivery.
Ensuring Compliance and Payment Accuracy:
Providers must maintain accurate and complete records of support delivery, adhere to invoicing requirements, and submit payment requests in a timely manner. Failure to comply with the Provider Payment Assurance Program or unsupported claims may result in repayment obligations to the NDIA or potential revocation of registered provider status.
If providers have concerns or require clarification regarding their responsibilities under the Provider Payment Assurance Program, it is advisable to contact the NDIA by telephone at 1800 800 110.
Conclusion:
As an NDIS provider, understanding the payment process and meeting the documentation requirements are crucial for smooth financial operations. By following the guidelines outlined by the NDIA, providers can ensure accurate invoicing, timely payment, and compliance with the Provider Payment Assurance Program. Maintaining comprehensive records of support delivery and adhering to the specific documentation guidelines for each support category will contribute to efficient payment processing and support the sustainability of NDIS provider businesses.
