Payment and Assurance
Participants who are self-managing their plan and related funding will pay the provider directly and obtain a receipt from the provider in order to acquit their expenditure against their plan. Where required, these participants will receive advance payments from the scheme in order to pay providers.
Providers who are working with participants whose plans are managed by the NDIA will be able to access the Provider Portal - an information technology (IT) system which supports electronic claiming and payment for supports. Electronic claims will be paid within 2 working days of lodgement. Providers who lodge electronic claims will not be required to lodge invoices. Providers choosing to lodge paper invoices will be paid within 30 days.
Managing NDIS payments
Providers and participants are encouraged to enter into a written agreement to ensure that there is a shared set of expectations about the delivery of supports. The NDIA has developed a Model Agreement to assist in this process.
An agreement should establish the key arrangements for the delivery of the supports. This includes what the arrangements are for the payment of fees, what happens when either party cannot keep an appointment, and what will be included in the service fee.
The payment and receipt of supports are commercial transactions between the participant and the provider. Any disputes will need to be resolved between the two parties, or through consumer law. The NDIA will not become involved in disputes about payments unless the funds are managed by the NDIA and the provider has been deemed to have breached the NDIA Terms of Business.
Co-payments are not required for participants in the NDIS. A participant will agree their reasonable and necessary supports with their NDIS planner. The fees payable for these supports will be set out in the plan in accordance with the relevant Price List.
A participant is free to choose a more expensive option at their own expense if it is not considered reasonable and necessary by the NDIA. Examples include cosmetic changes to fittings in home modifications or personalised features on assistive equipment beyond those considered necessary for the person’s disability.
Public holiday payment processing
There are no payment runs on Australian national public holidays. These holidays are Easter, Christmas, Australia Day and Anzac Day.
On these days there will be no:
- Payment processing
- Transferring of payment information to the Reserve Bank of Australia
- Payment to Participants and Providers.
Payment requests through the Participant and Provider portals can still be made on these days. These claims will not be processed until the next business day, where this day also coincides with an NDIS ‘payment run’ occurring.
Providers and Participants are encouraged to make claims 48 hours before national public holidays. This will allow time for claims to be processed.