Updated: Aug 28
We all have questions… especially when it comes to the ins and outs of the NDIS. Sometimes finding the right answer to your question can feel a little overwhelming. Which is why we’ve pulled together the top questions (and their answers) that participants ask our team.
Who sets provider rates & can I negotiate a better price?
Typically, providers will decide their own prices based on the cost of delivering supports and services. However, they cannot charge more than the limit set by the NDIA.
For example: If the maximum rate for 01_011_0107_1_1 Assistance with self-care activity is $65.47 per hour your provider can charge anything up to $65.47 per hour.
With the increasing competition among the number of providers in the industry, some providers are lowering their prices to attract more clients. In these circumstances, it means that participants can secure affordable services that meet their needs without having to pay high prices… but what about the providers who are still charging the maximum price?
Although it shouldn’t necessarily be up to the participant to ensure they have a fair rate, negotiating with your providers can help you to make the most of your NDIS plan funding and use it how it is intended.
Why am I being charged for non-face-to-face supports?
A NDIS provider can charge for non-face-to-face supports if they are reasonable and necessary according to a participant's NDIS plan. Non-face-to-face supports refer to services that are provided remotely. This includes supports like telehealth services, online training programs, plan management services, remote therapy services and assistive technology support.
Over the past few years, these supports have become more frequently used by NDIS participants to access timely and cost-effective provider services despite not being physically present. Non-face-to-face supports can be particularly useful for participants who live in remote or rural areas or have mobility issues, making it difficult to access support in-person.
Provider should list non-face-to-face supports in a service agreement including the terms and conditions of charging for non-face-to-face supports.
Providers cannot charge for non-face-to-face supports unless the support has been delivered. If you notice a non-face-to-face support listed in a provider invoice, and you’re unsure of the charge you can contact our support team to request the invoice be on hold while you discuss the charge with your provider.
Are there any exceptions to reasonable & necessary?
If you have a NDIS plan, then you’ll know that your funding supports must be considered reasonable and necessary for you to claim them. However, technically there is one exception – plan management.
Although the NDIA states that funding for plan management is “separate to the reasonable and necessary funding of a participant’s NDIS disability supports”, this is because plan management can be considered reasonable and necessary by default.
Plan management does not technically fall under reasonable and necessary for one simple reason - if a participant requests plan management they do not need to provide any supporting evidence to justify why they need this support. For all other support funding, participants must provide supporting evidence to show why a support is reasonable and necessary.
In other words, there’s actually only one type of support that is ALWAYS reasonable and necessary – plan management.
That’s not to say there aren’t rare circumstances where plan management may be denied. This action only occurs if the NDIA believe there would be an “unreasonable risk of harm” by a participant being plan managed.
Can I use my funding to buy a mobile phone or washing machine?
NDIS funding for smart devices like an iPad or mobile phone, or white goods like washing machines or dishwashers, works the same way as most NDIS supports and services – you need to show they fit the NDIS reasonable and necessary criteria to receive funding.
In most cases, smart devices and white goods won’t be funded. This is because they are viewed as everyday items for all Australians. However, there are some rare circumstances where you may be funded.
If you have reviewed the reasonable and necessary criteria and determined you may be eligible for funding, the next step would be to discuss this with your LAC or NDIA representative.
Can STA funding be used for a holiday?
Short Term Accommodation (STA) is a claimable support under the NDIS for when you need to be away from your place of residence for a short amount of time. STA funding can be used for respite to support you and your carers, which can also give your carers a short break from their caring role. However, it’s important to note that STA is not a holiday. The NDIS cannot fund a holiday, so if a holiday is what you’re wanting then you’ll need to fund that yourself. What they could do is support you to plan a holiday. When you have your plan reassessment, you can let your planner know that one of your goals is to plan a holiday. You may receive funding in your capacity building budget which could help you to reach your holiday goal.
Do I need to approve invoices before they are paid?
Choice and control is an important part of your NDIS journey. This includes having choice and control over your invoicing options. Some participants prefer to have full control over their invoices and wish to approve each one, while others are happy for invoices to be approved as they are processed. Ultimately, you can tailor your invoicing preferences to suit your needs.
Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or email@example.com.