NDIS Plan Management Options Explained

ndis plan management optionsNDIS PLAN MANAGEMENT OPTIONS:

NDIS SELF MANAGED, PLAN MANAGED AND AGENCY MANAGED, WHAT IS THE DIFFERENCE?

 

Funding options for NDIS can often be confusing for clients. Often you may find yourself walking away with many questions. Here are your NDIS plan management options.

 

There are three different ways of managing your NDIS funding; Self-Managed, Plan Manged and Agency Managed. So how do you know which one is right for you? Read on to find out.

SELF- MANAGED NDIS

The burning question: “Can I manage my own NDIS funding?”

NDIS Self-Management means you have more choice and responsibility choosing your supports and the services you use. However, along with self management does come more responsibility. You have to manage and pay your own providers and have a good record keeping system. Read on to find out more.

Providers

Self-managing your NDIS gives you more freedom in the way you approach providers for your supports and services. Under NDIS Self-Managed Funding, you can choose anyone as long as no special licensing or qualification is required. They do not need to be a registered NDIS provider. This means that as long as your provider has an ABN (Australian Business Number) and you have determined that they are both safe and responsible enough to perform the task you need them to, they can be paid as a service provider by you, through your NDIS funding. Of course, only use licensed professionals when the task calls for it.

Pricing

When choosing a provider for your needs, under a Self-Managed NDIS plan, you can negotiate the costs on your own behalf to get the best value for money. This is an important part of self-management, as advocating for a reasonable price will allow you to save on expenses which may be needed elsewhere. Your funding is finite.

Paying Providers

Paying providers is not as daunting as you might be led to believe. There are two ways of doing this: you can submit a claim either before OR after you receive your services.

Submitting a claim before you receive your services ensures that you have the money to pay your provider before your appointments. This make the process quicker and doesn’t leave you with a provider chasing their money.

If your provider is okay with a post-service provision claim, then you can use their invoice to claim the funds after you’ve had the appointment. Either way, allow at least two days to receive the money after submitting your claim. You can do this through the online portal, or by downloading the NDIS manual claim form, printing it out, filling it in, scanning it and emailing it through.

Your NDIS Money

Your NDIS money is usually allocated into separate areas during your NDIA meetings. This is where you decide how much money needs to go into which allocation to meet your goals, as long as it is reasonably necessary. Using NDIS Self-Managed funds, you can move money between these allocations more easily, provided you have the need.

Invoices and Receipts

All documentation surrounding your NDIS money HAS to be kept and maintained in a reasonable state while using NDIS Self-Managed funding. This makes auditing more efficient and allows you keep track of your spending. This is an important part of self-management, so make sure that when deciding which management option you want to use, you ensure that all financial documents are kept and maintained in an appropriate manner. Always remember that financial paperwork must be retained for a minimum of five years.

Plan Meetings, Goals and Supports

NDIA meetings. This is the time to lay it all out there and get down to the bone with the officials who will be allocating your funding. Before going into any NDIA meetings, make sure that you have a list  to refer to which have all of your goals, the steps you think that are needed to get there and the types of supports you believe you will need to get there. These meetings will determine everything to do with your NDIS plan. It is always a good idea to bring a close friend or family member who have your best interest at heart, who you can rely on to help you with any big decisions. This is the same with any management plan.

Pros and Cons

Like anything in life, there are positives and negatives. Under a Self-Managed NDIS Plan, you can expect:

Pros

  • Flexibility in choosing your service providers, as they are not required to be registered NDIS providers
  • More choice in the management of your funding
  • Flexibility to move your money from one allocation to another as you require it to meet your goals and access services you need
  • You can access peer support groups or employ your friends or family as a service provider to help you to self-manage your NDIS plan
  • If managing your own funding becomes too overwhelming, you can always hire a Self-Management Planner using your funding. You can approach your Local Area Coordinator (LAC) for help.

Cons

  • You must have the capacity and the means to maintain good records of any financial interactions with the NDIA and service providers in case of an audit.
  • While you are able to negotiate your own price for some services, because you aren’t restricted to the NDIS Price Guide, providers can demand more money for their services.
  • You need to have the time to engage with service providers and to pay invoices
  • You will need to deal with complicated paperwork and make agreements with service providers which you will be obliged to follow.
  • You may end up with a poor service that isn’t governed by the NDIA

Remember

You can always make changes to your plan or goals at any time. If your circumstances change and priorities shift, it’s good practice to keep the NDIA up to date, so together you can ensure all of your needs are being met and your NDIS money is not being wasted on services and products that you no longer need.

 

What is Plan-Managed NDIS?

Plan-Managed NDIS is when you hire a planner to manage your NDIS plan for you. Your planner HAS to be a registered NDIS provider. The money that pays for a plan manager is completely separate from your other funds and does not sacrifice money in other allocations. The NDIA will pay your plan manager for you, and your plan manager will pay all other invoices and providers.

Providers

Under a Plan-Managed NDIS, you can again use both NDIS registered providers and any providers who are not NDIS registered. This allows you a certain freedom in choosing the appropriate service providers which you need to access. Remember, you need to ensure that any service provider which you engage is suitably qualified for the task, practice safely in their respective industry and are generally a good fit and reasonably necessary to achieving of your goals, as set out in your NDIA meetings.

Pricing

Under a Plan-Managed NDIS, your plan manager, unlike a Self-Managed NDIS plan, is restricted to the NDIS price guide. This helps to keep your spending down. NDIS registered providers should be aware of this, and should not demand more money, however if they do, and you are still wanting to use the provider, you will be responsible for the out-of-pocket difference. This is not reimbursable. As always, make sure that the service you are contracting is necessary to achieving your goals.

Paying Providers

Under a Plan-Managed NDIS plan, your plan manager will be responsible for paying all invoices and keeping records maintained and up-to-date. There should ideally be little to no hassle for you surrounding the payment of invoices or record keeping.

Your NDIS Money

Under a Plan-Managed NDIS, you still need to attend NDIA meetings to determine what you need and how your funding will be allocated. After that, you can keep track of your budget through the NDIS online portal which the NDIA will have supplied. Your plan manager will keep track of and maintain all financial records to ensure that you remain complaint with any potential audit.

Pros and Cons

Pros

  • Your plan manager can negotiate with providers to pay less than the NDIS price guide
  • Flexibility in choosing service providers, as they do not have to be NDIS registered
  • Your plan manager will pay for all services and store all invoices for you
  • Your manager will take care of your funds, so you won’t need to use the online portal

Cons

  • If you choose a provider who charges more than the NDIS price guide, you will need to pay the difference out of your own pocket
  • You could end up with hiring a poor performing plan manager – always get recommendations
  • You may be left feeling somewhat out of control of your plan – It is essential that you find a plan manager who communicates well and keeps you informed.

What is NDIA-Managed NDIS?

 

NDIA-Managed means that your NDIS funding will be managed by the National Disability Insurance Agency. It is a stricter, more lean kind of plan, however, it leaves all of the worries out of your hands.

Providers

Under an NDIA-Managed plan, all service providers MUST be NDIS registered. The NDIA will work with you to find the providers from their list of NDIS registered providers that will best suit your goals and circumstances. This will all be covered in your NDIA meetings. Again, it is advisable to bring a support person with you, who has your best interests at heart. All bookings must be made through your NDIS online portal.

Pricing

Under an NDIA-Managed plan, you can expect the same kind of pricing as with a plan-managed NDIS plan. The NDIS price guide will apply to all providers, and if they charge more than the NDIS price guide allows, you will be responsible for paying the gap.

Paying Providers

Under an NDIA-Managed plan, your service providers claim the payment themselves through an online portal. You should have nothing to do with this side of the plan at all. All records are maintained and kept by the NDIA.

Your NDIS Money

On most occasions your NDIS funding will be managed solely by the NDIA under an NDIA-Managed plan. They will take care of all money-related issues, leaving you with less responsibility. You can always keep track of the financial side of your plan through the NDIS online portal provided to you, as a means of staying in the loop. You will, however, need to seek approval for ALL purchases from the NDIA surrounding your NDIS funding.

Pros and Cons

Pros

  • The most stress free NDIS plan
  • No need to worry about financial matters or record keeping
  • You are able to choose from a range of NDIS registered providers
  • You can keep track of NDIA spending through your NDIS online portal

Cons

  • You will still need to use your NDIS online portal to make appointments
  • You cannot negotiate prices with providers to stretch your money further
  • You will need to seek approval for any and all purchases you make using NDIS funding
  • It might leave you with less responsibility, but it also leaves you with less of a buffer regarding financial decisions.

Summary

Remember, no matter what plan you choose, it will be up to you to tell the NDIA what you need, what your goals are, and how you want to achieve them. Each plan management style has its own pros and cons. It is entirely dependant on what you are capable of handling, the kind of time you have on your hands, and how much control you want, or are willing to allow the NDIA or a plan manager to have. At the end of the day, your NDIA meetings are where it all happens. If anything changes, make sure to tell the NDIA at your next review or meeting so that you are getting the right kind of help that you need.

 

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