When you receive your NDIS plan, the funding provided is based on what the NDIS consider to be reasonable and necessary for your needs. However, there are circumstances where your NDIS funding may be exhausted prior to your reassessment date leaving outstanding invoices and an inability to pay for future supports. Even if you have the best intentions, this situation could occur which is why understanding what payment enquiries are, how to avoid needing one, and what to do if you are in a difficult situation can make a difference.
What is a payment enquiry?
A payment enquiry is the process of requesting additional funding to cover supports that have already been provided when there is no funding available to cover the cost of the supports.
If you are in a situation where you need to make a payment enquiry, this must be submitted manually via the Complaints and Enquiries area of the PRODA portal.
Why payment enquiries should be avoided
Payment enquiries can be a stressful and lengthy process, which in most cases are unlikely to be approved by the NDIS unless a change of circumstances has been submitted and approved prior to the enquiry.
Having choice and control under the NDIS also means that participants are responsible for how their funding is spent. Which means that if the NDIA rejects a payment enquiry, the participant is responsible for paying the invoice out-of-pocket. Providers can choose to pursue or not to pursue the debt. If the circumstance occurs where a provider decides to pursue the debt, this is between them and the participant. Plan Managers are not responsible for making or pursuing the payment on behalf of a provider.
What happens if the NDIA rejects a payment enquiry?
Following a rejection, First2Care cannot make another payment enquiry unless new information or evidence is provided. If the NDIA does reject a payment enquiry, the financial arrangements moving forward are between the participant and the provider.
What to do if overspending is unavoidable?
The best course of action when it comes to payment enquiries is to put tools and supports in place to prevent the need in the first place.
If overspending is unavoidable, you should:
Contact the NDIS as soon as possible if your needs have changed, that way you may be able to request a plan reassessment or plan variation before overspending occurs
Talk with our team about budgeting strategies and guidance on how to reduce your spending while also ensuring you meet your needs and goals
Regularly review your monthly statements or log on to your personal online portal whenever you want to view your budget status in real-time
Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.