Working with Self-Managed Participants and Plan Managers

Working with Self-managed NDIS participants and Plan Managers

NDIS participants have three ways of managing their NDIS funding:

Agency managed - The National Disability Insurance Agency (NDIA) manages the participant's funds and pays registered NDIA service providers directly.
Plan Management Provider managed - A Plan Manager is employed to support an NDIS participant to manage their budget. The Plan Manager requests invoices and undertakes payment on behalf of the NDIS participant.
Self-managed - The NDIS participant or nominee manages their own funding and payments.

Visit the Handbooks Page to download the Working with Self-managed NDIS participants and Plan Managers handbook. (Free for NSW sole traders and NDP Sole Trader members.This email address is being protected from spambots. You need JavaScript enabled to view it. to find out more.)

Summary

How does this impact Service Providers?

Service Providers who are working with Self-managed NDIS participants will normally liaise directly with the participant to organise the supports and services that will be delivered. Assuming the provider and participant agree, providers can charge above what is listed in the NDIS Price Guide. Self-managed NDIS participants will typically use the NDIS Price Guide as a benchmark when they negotiate pricing with service providers. Whatever price is agreed upon needs to be indicated in the Service Agreement between the participant and the provider. Read more information on Self-Management.

Plan-management explained

What is Plan-management

Plan-Management is one of three NDIS Plan Management options. Plan-managed NDIS participants will appoint a Registered Plan Management Provider to manage some or all of the funding in their NDIS plan. Providers will typically send the invoice to the participant who will then forward it on to the Plan Manager for payment. Alternatively, if the participant agrees, the provider can send the invoice directly to the Plan Manager. The Plan Manager will process a payment request and facilitate the payment to the service provider directly. A Plan Manager will keep all records on behalf of the participant.

Plan-managed NDIS participants have the flexibility to access the supports and services of unregistered providers, however, they are required to adhere to the price limits listed in the NDIS Price Guide. Providers need to be aware of the distinction between Self-management and Plan-management as it will affect the price that can be charged.

How does this impact service providers?

Service providers who are working with Plan-managed NDIS participants will typically liaise with both the participant and the Plan Manager regarding the processing and payment of invoices. Providers, regardless of whether they are NDIS registered or not, will not be able to charge above the prices listed in the NDIS Price Guide. This can create difficulties for providers who are unfamiliar with the NDIS and the pricing regulations that are in place. To avoid this issue, providers need to have a good understanding of the Price Guide and when it is applicable so that they don’t charge more than what can be recovered from the participant’s NDIS plan.

Questions to ask a Self-managed participant before providing services

Providers can take steps to ensure efficient service delivery and minimise the likelihood of payment delays by asking participants some key questions before they start working with them:

Is your NDIS plan Agency-managed, Plan-managed or Self-managed?
Are the services I’m providing likely to be provided across more than one NDIS plan period?
If yes, what is the end date of your current NDIS plan?
Does your NDIS plan contain the necessary support category or categories (i.e. Improved Daily Living, Assistance with Social and Community Participation, Improved Relationships etc.) so that you can submit Payment Requests for the services I am providing?
To the best of your knowledge, do you know if there is sufficient funding in your NDIS plan to cover the services agreed upon (as per the Service Agreement)?
What is your preferred method for receiving invoices?
Apart from yourself, is there anyone else you would like me to provide copies of invoices or receipts to?
Would you like to provide details of an alternative contact person if you are unavailable?