After a brief period of public consultation, the Australian Government has introduced new rules designed to clarify the supports participants can (and can’t) spend their National Disability Insurance Scheme (NDIS) funding on.
The rules, which came into effect on 3 October 2024, mean participants can only use their funding to purchase ‘approved supports’.
To help everyone better understand what’s approved – and what isn’t – support lists have been released, and the rules around how decisions are made have been explained.
The concept of a ‘replacement support’ has also been introduced, allowing the National Disability Insurance Agency (NDIA) to substitute existing NDIS supports or supports in a participant’s plan with a different service, item, or piece of equipment. Only some supports can be replaced and only if the NDIA approves the purchase in writing.
Participants can also continue to access the stated supports in their plans, as well as supports found to be reasonable and necessary by the Administrative Appeals Tribunal – even if those are now excluded.
This page on the NDIS website contains all the information you need.
The new support lists present a big change in the NDIS and come after the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Bill 2024 passed through the Parliament of Australia and became law.
“We now have a central place, set in law, where NDIS participants, their families, carers and providers can go to see what they can use their NDIS funds for,” said Bill Shorten MP, Minister for the NDIS.
“While there have been administrative guidelines previously, we have made it much easier for participants and providers to understand what funding can and can’t be spent on.”
There’ll be a ‘transition period’ for the first year of the new NDIS support lists to give participants and providers time and space to learn and understand them. During this time, the NDIA says it’ll work with participants and take an ‘educative approach’.
If you’re unsure what you can spend your NDIS funding on, you can speak to your NDIA planner, Local Area Coordinator, Early Childhood Partner, or support coordinator. Alternatively, you can call the NDIA on 1800 800 110.
And of course, we’re here to help. If you have any questions, you can email us at enquiries@myplanmanager.com.au or call us on 1800 861 272 from 8am-5.30pm, Monday to Friday.
Updated 13 February 2025
How can a neurodivergent workforce transform from simply surviving at the office to thriving in a fulfilling career?
Embracing the strengths of neurodivergent people isn’t just good for individual employees, but there’s a strong business case for it too – with satisfied staff who feel supported to give their all at work likely to stay put for longer in an organisation they can see themselves reflected in.
We’ve got the information to get you started, and insights from people with lived experience. Whether you’re a jobseeker empowered to find a supportive employer or a business looking to build on the strengths of neurodivergent staff, it’s all here.
South Australia is leading the nation in exploring how better support for people who are neurodivergent can also deliver wins for businesses.
The South Australian Government’s Office for Autism has Autism Works, a program for organisations and individuals to tap into the autistic strengths of employees and find out what accommodations can help support employees to not only perform at work but thrive in their professional environment.
Dr Emma Goodall, Director of Strategic Translational Research in South Australia’s Department of Premier and Cabinet – and founding director of the Office for Autism – says all employers must comply with Federal and state/territory-based legislation relating to employment and disability discrimination laws.
“Employees need to be able to do the work they are hired to do. They can ask for reasonable accommodations to make this easier and their output more effective, as long as the accommodations are possible within the context – for example, a surgeon cannot work from home whilst performing surgery,” says Emma.
However, accommodations can potentially support the entire workforce, she adds.
“The Office for Autism provides a template for an employee and employer to look at and agree on reasonable accommodations together,” she says. “This can be used for other reasons and not just for neurodivergent employees.”
Examples of accommodations could include:
Here are the resources the Office for Autism offers.
Having said all that, it doesn’t mean the path to acceptance and inclusion isn’t without twists and turns.
While disability discrimination is illegal, there’s always the risk that people who disclose their diagnosis or ask for accommodations may be subject to unconscious bias. However, Emma (who is autistic herself) says it’s vital that employers and senior staff understand the whole picture.
“It is illegal to discriminate based on disability or a range of other factors. An issue for individuals who perform better with accommodations is that their potential can sometimes be overlooked, and this can come across as discrimination,” she says.
“It is useful to ensure that managers know how the accommodations are working and the positive impact that they can have.”
Being wildly supportive of neurodivergent employees has paid dividends for Cherie Clonan of The Digital Picnic.
Cherie received an autism diagnosis as an adult and her Melbourne-based digital marketing training and management agency is welcoming of neurodivergent employees.
“I think that being a workplace designed with neurodivergence at the forefront benefits all,” she says. “Our neurotypical employees thrive in a neurodivergent workplace – it’s not harming anyone, rather, it’s radically benefitting all.”
“Our business genuinely benefits from neurodivergent strengths. For example, our content design specialists think in content and video production, I watch them and think, I could never! Our staff usually specialise in an area which is a special interest to their autistic or ADHD brain, they hyperfocus and bring intense passion… other workplaces could only dream of having someone so dedicated.
“Our clients constantly give us compliments, and when I read the bullet points from clients, every point is a neurodivergent strength.”
And Cherie’s leadership in business was also recognised at the 2024 B&T Women in Media Awards, where she won the Glass Ceiling Award and was recognised as Woman of the Year.
Cherie says The Digital Picnic’s structure of inclusion has translated into better staff retention and consistency for the business. That makes dollars and sense.
“For other businesses who want to emulate what we do, the upsides are that I have double the retention rate with every single person on my team. The industry average is two years, our minimum retention is usually four years, and our average is actually six to seven years with our business,” says Cherie.
“Think about how expensive it is to re-hire, it’s about $33,000 per person and that’s something I’ve been able to avoid when my staff are in a psychologically safe, truly inclusive setting that makes them feel good about the work they do.”
Emma agrees, saying inclusive workplaces allow people to feel safe and “bring their best selves” to the office or job site.
“When we support people to work effectively and authentically, people can bring their best selves to work. This always benefits the employer through more productive and effective staff. It can also support people’s wellbeing and promote worker retention,” says Emma.
While it’s widely understood that protections against disability discrimination exist, that doesn’t mean every employer is utopian for people who are neurodivergent.
Cherie says you don’t need to disclose your diagnosis to an employer if you don’t feel like it’s the right move for you.
“I think honour that fear. I know that what I’m describing for The Digital Picnic is not normal (for most workplaces) – it’s radical, inclusive and accepting, and that what happens when you have lived experience at the helm of a business,” says Cherie.
“It’s not the norm, there are a lot of workplaces that are genuinely unsafe to come out as neurodivergent. If you have a feeling of fear, I would honour that gut instinct. I know that neurodivergent people can clock pretty well when it’s not safe and our pattern recognition is usually spot on.
“You’re okay to not disclose, not come out if you don’t feel safe to be able to do so. It’s realistic to know that in 2024, we are not quite there at that spot where it is completely safe to come out as neurodivergent in every workspace.”
The Autism Works program has information for businesses at every step of the process, from recruitment and interviews to inductions and making reasonable workplace adjustments.
Most adjustments are simple to implement – this guide can help employers and employees to work together to find the right adjustments.
For more costly changes, financial assistance may be available. Find out more here.
And remember, just as accessibility for people with physical disability extends to helping the entire community (think about how a ramp allows wheelchair users and people with walking frames to go up the kerb, but also helps caregivers with prams, delivery people with sack trucks and travellers with rolling suitcases), adjustments designed for people who are neurodivergent can benefit a neurotypical employee as well.
Cherie says businesses looking to replicate The Digital Picnic’s success as an inclusive employer need to be committed.
“I think about workplaces that want to benefit from neurodivergent strengths, so they go all in on neuroinclusive hiring, but then the safety stops, and the workplace isn’t safe for the neurodivergent person,” says Cherie.
That’s why she says ongoing education and training for all staff is key.
“I’ve learned in my life the best way to facilitate change that you want, especially in the workplace, is through education,” says Cherie.
“What does the learning and development budget look like at a company level? Can you bring someone with lived experience in to educate in that space and teach at a leadership level how to be more neuroinclusive?
“When there is that buy-in, there is a ripple effect, and I’ve been hearing from neurodivergent folks saying that then about six to 12 months later, their workplaces have become significantly safer. Following the advice of someone with lived experience means employers know better and do better. Education is key.”
While many people recognise neurodivergent traits in themselves without ever pursuing a formal diagnosis, a formal diagnosis can be helpful. But it’s expensive – ADHD and autism diagnoses can cost thousands of dollars and wait lists are long.
That’s why The Digital Picnic funds staff to pursue an assessment if they choose.
“All I ever want to do is create the most neuroinclusive place I possibly can. This is about knowing more so you can do more, and part of that is deeply understanding who we have on our team,” says Cherie.
“For our team, they benefit from knowing what accommodation they need at work in order to thrive. A lot of our folk are exactly like me – a couple of kids have gone before them for diagnosis and that’s $4500 per child, so by the time they get to themselves they can’t afford or justify paying for an assessment, but at the same time it couldn’t be more important for them.
“Some of them have gone down that path, funded by us, and incredible things have come through that – professional and personal gains, even some being able to access NDIS funding, which has transformed their lives out of work. I’m so happy that a piece of paper has helped them get even more support outside of work.”
But for those who don’t want a formal diagnosis, Cherie says self-identified accommodations are accepted and just as valid.
“I genuinely believe there is so much privilege attached to a piece of paper, but the folks who are self-identifying are just as valid as if they had the piece of paper,” she says.
“You’re never ‘just’ someone who self-identified. We know that most people don’t wake up one day to spend hours, weeks, months, years researching if they are neurodivergent unless they have a deep feeling that it applies to them.”
Emma believes inclusion is about more than just paid work – true inclusion has wide-reaching benefits for the entire community and reframes perceptions and expectations of people with disability.
“I would like to see the positives of autism – high levels of knowledge in areas of interest, loyalty, ability to hyperfocus, autistic joy, autistic communication – as a standard for clear communication… and to do this, I think it is about sharing more stories about the good lives that many of us live as adults,” says Emma.
“However, this needs to be done sensitively and balanced with the stories about how supports help us to live those good lives. Being a volunteer is as meaningful as being in employment.
"What a good life looks like is different for everyone."
30 September 2024
In early 2024, the National Disability Insurance Agency (NDIA) announced it would take extra time to check some claims submitted by participants and providers before they’d be paid – resulting in payment delays.
The payment delays are here to stay, but there are things you can do to help your claims get through the queue.
It’s true – as a National Disability Insurance Scheme (NDIS) plan manager, My Plan Manager plays a part in processing the claims of our clients and their providers, but the Agency plays a part too.
Here’s a quick summary of how it works:
Some claims are scrutinised by the NDIA’s pre-payments team. When this happens, the Agency may contact us to say a claim isn’t compliant, or it needs to be amended, or more information is required.
If a claim isn’t compliant, the NDIA will reject it. This will be communicated to us, and we’ll let you know.
If the NDIA requests more information about a claim, we’ll let you know that too. If the information it needs isn’t provided, the NDIA will keep the claim on hold – but once the right information is submitted and the claim is validated, it’ll be added to the Agency’s next payment run. The NDIA will notify us when to expect the funds, and we’ll be sure to let you know.
The simplest way to get your claim through the queue quickly (and money into your account faster) is to make sure the invoices you submit are structured correctly. They need to have:
If you’re a client submitting an invoice on a provider’s behalf, or a request for reimbursement, we recommend doing that through our purpose-built client portal.
And if you’re a provider, we suggest you use our provider portal – it makes creating, uploading and submitting invoices a breeze. Plus, you can track payment status in real time.
If the NDIA has indicated its decision to cancel a claim, or part of a claim, that’s not reviewable – meaning you can’t seek to change it.
If you want to provide the Agency with feedback about its decision or any other information relevant to a claim, you can do that here.
If the NDIA is holding a claim for a significant period of time, like weeks or months (even once information its requested is provided), you can contact the Agency directly through an enquiry or complaint. However, be sure to speak with us first – we may be able to assist you.
If you have a roadblock with getting paid, we’re here to guide you. You can email us at enquiries@myplanmanager.com.au or call us on 1800 861 272 from 8am-5.30pm (SA time), Monday to Friday.
Updated 13 February 2025
You’re a provider in the National Disability Insurance Scheme (NDIS). You’re supporting a client and we’re their plan manager.
You’ve scoped out their supports, you’ve signed off on a service agreement, and you’ve started putting your expertise to work. So, when the supports have been delivered and it comes time for invoicing, of course you’re going to want fast, efficient processing of your claims.
Ideally, you’ll have a service agreement that lays out the supports you’re engaged to provide, and the terms of your agreement (including price, delivery dates, terms and conditions) in place with your client and a copy will have been provided to us.
With that in hand, take a look at this provider letter which contains everything you need to know about claiming through us and you’ll be on your way.
Enter the My Plan Manager provider portal.
Our provider portal offers ease and transparency when it comes time to claim. It lets you invoice quickly, and you can check the status of your claim at any time. Just like a banking app, our provider portal lets you see every invoice you’ve submitted to us – so you’re never in the dark about your claims or where they’re at in the queue.
We’ve made our provider portal as simple and powerful as we can, so you can breeze through the platform and get claiming done fast.
Here’s a look at what our provider portal can do (plus a virtual tour at the end!).
To generate an invoice, simply type in your invoice number, add your client’s name, and key in the date and quantity of the supports provided, the price or hourly rate applied, and your Australian Business Number (ABN).
You can upload and submit invoices for our review via the provider portal. Alternatively, you can email claims to accounts@myplanmanager.com.au, but claiming through our provider portal gets your invoice into our queue quicker!
Having visibility of past and current claims and the ability to look over invoices provides a complete record of what you’ve charged your clients, and when. Your information is securely stored and available for you to view at the click of a button.
Our provider portal has the latest security features, so your privacy and information are safe and protected.
Best of all, there’s no password required! Multifactor identification means you can log in via SMS or email.
At My Plan Manager, we work to process claims swiftly. But the National Disability Insurance Agency (NDIA) says that while valid claims will be paid within two or three working days, some payments may take up to 10 working days to be processed – allowing time for the Agency to undertake more rigorous investigation of claims.
With fraud detection top of mind for all NDIS stakeholders, the Agency’s timeline is designed to protect everyone. So, although it may take longer for you to receive payments related to your invoices, there’s a good reason for it.
Keen to see our provider portal in action? Step through this virtual tour to familiarise yourself with the different areas and features of the platform.
To get started inside our provider portal, you need to request a log in, which you can do here.
We’ll ask you to provide some information, like your business name, ABN, email address and mobile number, and then we’ll get you set up.
Next, visit this link and click ‘Log in’.
Type in your email address or mobile number and we’ll send you a code.
Enter the code, and you’re in!
If you have any questions about our provider portal, our friendly team is here to assist. You can call us on 1800 861 272 from 8am–5.30pm (SA time), Monday to Friday or email us at enquiries@myplanmanager.com.au.
Updated 13 February 2025
Cast your mind to headline news, and chances are you've been exposed to coverage of confronting cases of abuse or neglect of people with disability.
Taking action when risks are identified or serious incidents occur is a fundamental responsibility we all have as humans, and in the National Disability Insurance Scheme (NDIS) it’s also a condition of provider registration.
Registered providers have a wide array of responsibilities towards participants in the Scheme, including telling authorities about reportable incidents – events or allegations that need to be swiftly recognised and acted upon – and there are consequences when those obligations aren’t met.
But not every provider knows what a reportable incident is, what to do if they become aware of one, or what the extent of their responsibility to participants and others is. That’s why we went to Belinda Toohey, Director of disability service provider, Including You, to unpack this topic.
Belinda works with NDIS participants and has a wealth of knowledge in the area of reportable incidents. Here’s what she told us.
A. Reportable incidents in the NDIS context are serious events or allegations involving NDIS participants that require notification to the NDIS Quality and Safeguards Commission (known as the NDIS Commission). They can include:
There may be incidents that don’t sit clearly in these areas. If in doubt about whether an incident is reportable, I suggest making a phone call to the NDIS Commission to discuss the situation.
A. When a reportable incident is reported, it lets the NDIS Commission investigate, provide support, and take action to prevent future occurrences.
You cannot only rely on the NDIS Commission to investigate or take action – it’s responsible for participants and the Scheme itself. Providers also have to investigate and provide reports to the NDIS Commission and, depending on the type of incident, the Commission will call the provider back and work with them.
When a reportable incident isn’t reported, it risks the safety of participants and can also result in regulatory consequences for providers. It shows a lack of accountability.
When a provider tries to hide something or doesn’t act, it usually comes out somewhere else too, and we know there are serious consequences when providers don’t report.
We’ve seen an increase in banning orders and also an upturn in the number of providers being shut down due to lack of reporting, which places participants at risk. In extreme circumstances, this risk has resulted in the death of a participant.
A. Providers are obligated to promptly report incidents to the NDIS Commission to prioritise participant safety, adhere to regulations, and uphold trust. This commitment fosters transparency, ensures accountability, and enhances service quality.
Given the vulnerability of our cohort, who are at higher risk of abuse and mistreatment, regulatory oversight is crucial. The NDIS Commission offers comprehensive reporting guidelines and resources on its website, serving as a valuable reference for providers when reporting incidents. This ensures reporting is accurate, timely, and in line with regulatory requirements, ultimately supporting a safer and more accountable environment for NDIS participants.
It’s every provider’s role to build a culture that encourages reporting and ensures zero tolerance for anyone breaching the NDIS Code of Conduct.
A. Providers are required to report incidents to the NDIS Commission within 24 hours of becoming aware of them. Additionally, they must submit a follow-up report five days later to provide further details and updates on the incident, as outlined in the reporting guidelines.
Reporting is done through the NDIS Commission's website, with designated roles within the organisation for notifying and approving incidents submitted to the Commission.
The obligations of reporting include ensuring the accuracy of information, cooperating fully with investigations, and implementing corrective measures as necessary. In cases of uncertainty, providers are encouraged to contact the NDIS Commission for guidance and clarification. The NDIS Commission will then determine the appropriate actions to take based on the information provided.
When reporting, it's essential to include:
If you’re a provider who’s reporting an incident to the police, be sure to ask the responder for their badge number and the police station they’re working from. The NDIS Commission will ask you for this information so it can follow up with the correct person.
This structured reporting process ensures compliance with regulations, supports effective incident management, and contributes to maintaining a safe environment for NDIS participants.
It’s important that every provider understands the process for reportable incidents, and also that the NDIS Commission’s reportable incident process isn’t that easy to use and the response time varies from one or two days to six months (depending on the type of incident and those involved).
A. Handling uncertain incidents within the NDIS framework requires a careful and proactive approach to ensure participant safety and regulatory compliance.
When faced with incidents where there’s uncertainty or suspicion, providers are encouraged to adhere to the following guidelines:
1. Prompt reporting – Despite uncertainties, if there’s any suspicion that an incident may compromise participant safety or wellbeing, it should be reported promptly to the NDIS Commission. Early reporting allows for timely intervention and investigation.
2. Thorough documentation – Document all relevant details and observations related to the incident. This includes dates, times, individuals involved, and any other pertinent information that could aid in understanding the situation.
3. Seek guidance – If unsure about whether an incident should be reported, providers should reach out to the NDIS Commission for clarification and guidance. The Commission can provide specific advice based on the nature of the incident and help with navigating reporting requirements.
4. Internal review – Conduct an internal review or assessment of the incident. This may involve gathering additional information, consulting with relevant staff, and assessing potential risks or implications.
5. Participant support – Ensure affected participants receive appropriate support and assistance. This may involve coordinating with other service providers, healthcare professionals, or advocacy services as necessary.
6. Compliance with policies – Follow internal policies and procedures regarding incident management and reporting. This helps maintain consistency and ensures all incidents are handled in accordance with regulatory standards.
7. Continuous improvement – Use incidents as learning opportunities to improve practices and policies. This may involve reviewing existing protocols, providing additional training to staff, or implementing preventive measures to minimise future incidents.
By following these guidelines, providers can effectively manage uncertain incidents within the NDIS framework, prioritise participant safety, and uphold the integrity of disability support services. This approach not only ensures compliance with reporting requirements but also promotes a proactive stance towards safeguarding the wellbeing of NDIS participants.
A. Exemptions or variations can be considered in specific circumstances. These might include situations where a provider’s governed by other regulatory bodies that have similar requirements, or where the NDIS Commission determines that certain conditions warrant an exemption or variation.
If you have a specific situation in mind, it's best to contact the NDIS Commission directly or seek advice from a legal or compliance expert familiar with NDIS regulations.
The NDIS does offer anonymity and protection when reporting events and it’s best to call the NDIS Commission to talk this through. There are privacy laws in place, but there may be instances where the notifier’s identity may need to be known, depending on the reporting of the situation. In these instances, the NDIS Commission with let you know and support you through the process.
A. Providers should educate staff on reporting protocols, maintain detailed records, and seek guidance from the NDIS Commission resources or even from legal counsel when needed. They can also engage participant advocates for support.
Effective incident reporting in the NDIS is essential for safeguarding participants, ensuring accountability, and improving service quality.
Providers must adhere to reporting guidelines, prioritise participant safety, and seek support when uncertain about reporting obligations or incidents. They also need to follow the NDIS Code of Conduct and their own internal policies and procedures before reporting a reportable incident to the NDIS Commission.
Making sure providers and their teams understand what human rights are and how they apply them when carrying out their jobs is also a good guide to measure what’s acceptable and what isn’t.
In early 2024, the National Disability Insurance Agency (NDIA) announced it may take more time to check claims before they’re paid.
With fraud detection top of mind for all National Disability Insurance Scheme stakeholders, the Agency’s decision means it may take longer for participants and providers to receive payments related to invoices and/or claims for reimbursement.
To help reduce fraud and non-compliant behaviour, the NDIA has confirmed that, while valid claims will be paid within two or three working days, some payments may take up to 10 working days to be processed, allowing time for the Agency to undertake more rigorous investigation of claims.
Once a claim is paid by the NDIA, it typically takes one or two days for the funds to appear in your bank account.
Duplicate claims are also under scrutiny. If a duplicate claim is submitted within 14 days of an initial claim being made, the NDIA will review it for fraud and non-compliant behaviour.
We’re aware of the impact payment delays have on participants and providers, and we’re here to help.
Usually, the Agency doesn’t tell us why a claim is being reviewed. However, if we require your assistance, we’ll let you know what we need, and we’ll work with you to source the information the NDIA requires.
Payment disputes are rarely black and white, and between National Disability Insurance Scheme (NDIS) participants, their providers and other stakeholders, there’s often several shades of grey!
Few providers like the task of administration and invoicing, and fewer still enjoy the process of following up outstanding invoices.
We spoke with Around the Well’s Selwyn Child to explore common reasons why invoices go unpaid, strategies at your disposal to find a resolution, and ways to minimise not getting paid in the future.
An experienced NDIS support coordinator, Selwyn explains there are many reasons why a client may refuse to pay an invoice – or be unable to. Top of the list are:
So, what do you do when an invoice remains outstanding?
Selwyn says maintaining a professional, empathetic and solutions-focused approach is key.
“The aim is to achieve a resolution that respects the participant’s dignity and rights, while ensuring the provider can continue to offer their services,” says Selwyn.
“If a client hasn’t paid, it’s a provider’s responsibility to continue providing support where possible, especially if services are critical to the participant’s wellbeing.”
With this in mind, here are five strategies at your disposal to approach the situation constructively.
It’s an obvious first step, but often an effective one. When an invoice is outstanding, Selwyn explains a provider can have a conversation with their client, or their client’s representative, support coordinator or plan manager to find out why.
The reason could be simple, and quickly addressed. If not, more problem-solving may be needed!
If you find out your invoice hasn’t been paid because your client doesn’t have sufficient funds to cover the cost, they may be able to leverage flexible funding (if they have it). For example, they may be able to move funding from one funding category to another to pay for the services or supports you’ve delivered. That’s where a plan manager (like us!) or a support coordinator can assist a client by providing them with expert advice about their plan’s flexibility.
“Core Supports are generally the most flexible, allowing funds to be reallocated across different supports within the Core budget,” says Selwyn. “However, shifting funds between Core and Capacity Building or between Core and Capital categories usually requires a plan review and approval by the NDIS, and a compelling justification based on changing needs or goals.”
Selwyn says maximising the effectiveness of NDIS budgets and navigating the flexibility between different funding categories requires an understanding of the NDIS framework, particularly the principles outlined in Section 34 and the NDIS Pricing Arrangements and Price Limits.
In the instance of a client experiencing a significant change of circumstances that’s resulted in the exhaustion of their funding and your invoice remaining outstanding, their plan may require reviewing.
Selwyn explains that providers can, with the participant's agreement, advise either the participant or their support coordinator to initiate a plan review with the National Disability Insurance Agency (NDIA), in line with the NDIS framework.
It's important to note the NDIA is unlikely to allocate additional funds simply because the existing funds were depleted, particularly if this was due to how the plan was managed. But if the initial funding allocation proved insufficient due to a misjudgement of the participant's needs or if the participant's circumstances have evolved, necessitating different supports, then a request for a plan review is the appropriate course of action.
“This step is crucial for ensuring that participants receive the tailored support they need, reflective of their current circumstances,” says Selwyn.
“Providers can contact the NDIA directly for advice on how to proceed when a participant has run out of funding. The NDIA can provide information on the process for requesting additional funding or an early plan review.”
Remember, before having any conversations with the Agency about your client’s plan or funding, make sure you have your client’s consent, respecting their privacy and rights under the NDIS framework.
When insufficient funds isn’t the barrier to receiving payment, but client dissatisfaction is, Selwyn suggests getting to the root of the problem together, or with a neutral third party.
“Engage in open and empathetic communication with the participant to understand their perspective and address any concerns or misunderstandings directly,” he says.
“It’s crucial to review the service agreement together, as it outlines the expectations and obligations of both parties, and to discuss any discrepancies between the services delivered and the client’s expectations.
“If this direct approach doesn’t resolve the dispute, the provider can suggest involving a neutral third party to help facilitate a resolution.”
Selwyn adds that providers can also seek guidance from the NDIS Quality and Safeguards Commission, which offers resources and support for resolving disputes between providers and participants.
“Throughout this process, maintaining detailed records of services provided, communications, and attempts at resolution is essential,” says Selwyn.
“Providers should remain committed to finding a resolution that respects the client’s rights and needs, while ensuring that services are appropriately compensated.
“This balanced approach encourages a resolution that supports the ongoing provider/client relationship and upholds the principles of the NDIS framework.”
If a resolution hasn’t been found, providers can contact the NDIA for guidance about how to proceed.
The Agency can offer advice, and in some cases it can intervene. Make sure you’ve exhausted all available avenues for resolution first though, including internal dispute resolution mechanisms, mediation, and consultation with the NDIS Quality and Safeguards Commission.
There’s steps you can take to minimise the risk of your invoices going unpaid.
Clearly worded service agreements are key to managing the financial relationship between providers and their clients.
“Be sure your service agreement outlines the scope of services, payment terms, schedules, and the dispute resolution process,” says Selwyn. “Ensure the language is accessible and clearly understood by the participant.”
“Take the time to explain service agreements to clients, focusing on payment obligations and how services will be billed.
“Check they understand their plan budgets and how your services fit within them.”
Transparent pricing is vital too, and best practice providers are up front about the cost of their services, often providing a detailed quote alongside an explanation of the NDIS Pricing Arrangements and Price Limits and how their services are billed against it.
This clarity helps participants to budget for the supports they need, so they can work with the providers they choose.
To support clients and assist with continuity of payment, Selwyn recommends implementing a consistent billing cycle and issuing regular, itemised invoices that clearly correspond to the services provided.
He says regular progress reports that outline service outcomes and participant achievements can also help clients to see the value a provider delivers and open conversations about supports and the wider client/provider relationship.
“Establish open lines of communication for participants to express concerns or changes in their support needs,” says Selwyn.
“Being responsive and flexible can prevent minor issues from escalating.
“Providers may want to schedule regular meetings with their clients to review service agreements, discuss services and outcomes, and address any potential issues early in the picture.
“Keep detailed records of services provided, communications, and any adjustments to the service agreement. Documentation can help resolve disputes by providing a clear history of the relationship.”
From time to time, you may have heard about fees in the National Disability Insurance Scheme (NDIS) and wondered what they are, and when it’s okay for you to charge them.
Or, you might have queried how to present those fees to your clients, so they’re easily understood and justified, and so no curly questions come your way when you submit your invoices.
Brush up on your knowledge and find out which charges you can pass on to your clients and which you need to absorb by reading this breakdown of operational costs in the NDIS – drawn directly from the NDIS Pricing Arrangements and Price Limits.
And once you’ve gone through it all, make sure to talk with your clients and their support networks too – the sooner you open the lines of communication between them and you, the better!
An establishment fee is a once-off charge that covers the non-claimable time required to establish support arrangements with an NDIS participant. Providers who assist participants with the implementation of their NDIS plans can charge this fee if they have an agreement to provide supports for a minimum of 20 hours each month across three or more consecutive months. Examples include:
Personal care supports (Assistance with Daily Life) – supports delivered by providers in the Daily Personal Activities (0107) and High Intensity Personal Activities (0104) registration groups. The National Disability Insurance Agency (NDIA) sometimes refers to this category as Activities of Daily Living.
Participation supports (Social and Community Participation) – supports delivered by providers in the registration groups covering Participation in Community, Social and Civic Activities (0125), Group and Centre Based Activities (0136), Specialised Supported Employment (0133), and High Intensity Daily Personal Activities (0104) when delivered for community access or group supports. The NDIA can sometimes refer to this category as Social, Economic and Community Participation.
Note: If you’re an allied health provider, every support you deliver is aligned to a registration group. Registration groups are located inside the NDIS Pricing Arrangements and Price Limits, under Support Purposes, Support Categories and Support Items, and each item in the Support Catalogue specifies the registration group.
Providers can only claim one establishment fee per participant, regardless of whether they provide services to them through more than one registration group or support category.
Providers can charge participants for time spent on a range of non-face-to-face tasks – things they do when a participant isn’t present to ensure their client can participate in group or centre-based supports. Examples may include:
Providers can’t charge their NDIS clients for training and upskilling staff, supervision, or time spent on administration (things like processing claims or developing service agreements).
Charging a centre capital fee helps providers to meet the costs of running and maintaining physical premises.
The fee can be charged at a per participant/per hour rate if High Intensity Daily Personal Activities (0104), Specialised Supported Employment (0133) or Group and Centre Based Activities (0136) – items in the Assistance with Social, Economic and Community Participation category – are provided to the participant at the premises.
If supports are provided onsite and in the community – but the premises are always available during the period of support delivery – providers can claim the full centre capital fee.
The NDIA doesn’t set price caps for provider travel so, if participants are aware of the fees that are proposed and they consent to them, providers can charge as much or as little as they like.
The NDIS Pricing Arrangements and Price Limits separates the labour and non-labour costs associated with provider travel – with labour costs covering the time spent travelling to/with a participant, and non-labour costs addressing expenses like road tolls, parking fees, and the costs of running a vehicle.
Cancellations are common in the NDIS, and the NDIA has specific rules about charging participants for them.
We explained cancellations to participants in this article.
Where a provider receives a short notice cancellation from a participant (or a no show), they can claim 100 per cent of the agreed fee associated with the activity, subject to the NDIS Pricing Arrangements and Price Limits and the terms set out in the service agreement they have with their client.
Providers can’t charge cancellation fees for costs they didn’t incur, like mileage.
Find out more about cancellations by reading this provider-focused overview.
According to the NDIA, providers can’t charge for ‘meet and greets’ before or after services commence, and fees like credit card surcharges, late payment fees and administration fees can’t be passed on to clients.
NDIS participants aren’t liable for exit fees. But if they end a service agreement early, they may be charged a cancellation fee, depending on the terms of agreement.
The NDIS Pricing Arrangements and Price Limits is the best source of information about fees and charges. Outside of the Agency’s requirements, it’s up to a provider to decide what they’ll charge.
We encourage providers to be fair and transparent and to speak with participants before supports commence to explain what charges they can expect (or what fees they won’t ever see). Many providers offer quotes and explanations about how fees are billed, which can help participants to budget, and we advise our clients to make sure their providers set everything out in writing in a service agreement that's signed by both parties.
For more information about NDIS fees and charges, give us a call on 1800 861 272 from 8am-5.30pm (SA time), Monday to Friday.
Updated 13 February 2025
You’ve got the passion. You’ve got the experience. And you’ve got the vision. So how do you take it all to start or expand your National Disability Insurance Scheme (NDIS) business?
Whether you’re a therapist looking to start working for yourself, or a sole operator wanting to expand and bring on your first team members, taking informed, intentional and planned action before you branch out means you can build your business in a way that works best for your clients and rewards you as well.
So, let’s get started!
Peter Flynn is the Business Development Manager of Clinic Mastery, which exists to help allied health professionals grow their businesses. Importantly, Peter says it’s about working for the right reasons.
“We help other clinic owners to grow their clinics sustainably and we do it from an ethical standpoint that creates an amazing workplace where people want to work – so the business owner wants to be there, the team wants to be there, the clients love it, and the clinic does good in the community,” says Peter. “It’s about trying to find the balance between all of those.”
And everyone at Clinic Mastery can walk the talk, being former health business owners themselves. However, Peter says there’s a big difference between being a good health care provider and being a good business owner.
“My background is in physiotherapy. I studied exercise science and then a Masters in Physiotherapy, and I sold my two clinics in December 2022. I found my degrees didn’t touch on business at all – in fact, physiotherapy doesn’t even touch much on private practice, it’s geared towards hospital or aged care,” he says.
“You can be a really good practitioner, but the thing you find out quickly is being a good practitioner has zero correlation to being a good business owner. It’s a whole different skill set.”
Meanwhile, Anna Crump from Blue Iris, which specialises in support coordination and in-home support for people with psychosocial disability, says she’s witnessed business growth exploding in a very short time.
“There is enough work for everyone, and we celebrate collaboration over competition with other agencies, but there has been an explosion of support providers in south-east Queensland,” says Anna. “In northern areas of Queensland, from Sunshine Coast to north Queensland, there is a real lack of quality service providers, and it’s really hard to get services in remote areas.”
She says some business owners can be inspired to start quickly, without realising what they need to do to provide a safe, quality service.
“The NDIS is a multi-billion-dollar industry, so people will generally do stuff because they think they can, not realising what they need to put in place to do it well,” says Anna. “Having relationships with other providers in the sector is important.”
This seems obvious, but it’s so important and often overlooked – why are you going into business for yourself? What can you offer to your potential clients that will benefit them and you? And what’s the environment in which you’ll be operating?
Anna says it’s this initial planning which is vital.
“You have to find a niche and the best sort of service you would provide,” Anna says.
“You have to have a really robust business plan before you even take on clients. Know what the NDIS Quality & Safeguards Commission expects – there’s a lot on their website for you to learn about. Go into it knowing you won’t be the right provider for everyone and go into it to provide the best service. It’s not just about making money.
“Remember there should be a lot of safeguards in place because you are providing support to the most vulnerable in our society. There should be a lot of hoops to jump through, it is a really important role.”
Peter says it’s important to interrogate why starting your own business is your driving force.
“If what you want to do is aligned with working in employment, then keep doing it, because you can progress in your role quite far,” says Peter. “We sometimes think the only way is to start a business, but you do have to enjoy being in business, because it’s going to take a lot of time.”
“If you’re not feeling fulfilled in the role you’re currently in, have you had a chat with your boss? Is there a way to find more fulfilment in your current role?
“If there is a lot of uncertainty in your life it’s not a good time to start, because starting your own business never goes as smoothly as we would like.
“But, if you have all your ducks in a row and you have the drive and the desire to expand your creative flair, you want to increase your earning capacity and the capacity for freedom that owning your own business can create, then it’s worth looking at.”
Anna agrees and says there are clear pathways to promotion within Blue Iris.
“When we employ our support workers, we show that there are opportunities for career growth in the agency. We have support workers, senior support workers, team leaders and support managers, and a lot of our senior people came from starting as support workers,” says Anna.
“Look for progression before going out on your own. A lot of people think it’s going to be easier, but from a compliance and risk point of view, there's a lot more than what you think.”
Peter and Anna agree that it’s a lack of understanding around policies, contracts and position descriptions that can trip up new business owners. Knowing what to prioritise – and what to spend – is vital.
Peter says that a good accountant is worth their weight in gold – someone who knows how to do payroll, account for tax, pay superannuation on time, and educate owners on good financial practices.
And Anna says understanding both the federal and state legislation where you operate is important.
Peter says this is another milestone event, but if you can’t fulfil your clients’ needs on your own, it’s a step you’ll have to consider if you want to grow and expand.
“It takes a lot of courage,” he says. “It’s really scary when you hire your first person, you’re taking on risk whenever you increase your overheads.”
“Whilst it's easy now to say, ‘just hire your first person’, when we hired our first admin or therapist it was scary as hell. The other things it takes are a plan, and understanding when is the right moment to hire, who is the right person, and how does it fit into the overall business plan.”
Getting feedback from others can help ensure you’re hiring the person who’s going to align with your business, he adds.
Anna agrees that expert advice and feedback is key.
“I would recommend finding a mentor, linking yourself with amazing providers through networking, and attending sector events,” she says. “Find mentors in the sector who have high standards and are compliant, not by their own account but by the people receiving the service.”
“Take feedback, good and bad, and apply it, noting that you won't get it right all the time and that you won't be right for everyone.”
Anna says regular training for all team members has to be a priority.
“You need ongoing staff training, not just an induction period,” says Anna. “It’s about fostering the skills for your workplace and providing that ongoing training to get a quality service.”
And while professional development is compulsory for some allied health professionals, business owners should never stop working on their own learning and that of their business. This is especially true for clinicians making the transition to their own small business, where they lose the regular feedback from colleagues that’s part and parcel of working for a large organisation.
But that doesn’t have to be formal training or attending conferences and seminars. Peter sourced his own coaches and mentors – therapists who had treated him for injury.
“I decided I was going to hire three mentors to help me clinically. They were just people I’d seen as a patient, or people I looked up to. I simply said, ‘I love what you do, what would it cost for 30 minutes of your time to go over case studies?’ and everyone was very keen,” he says.
“I know a lot of younger clinic owners who create a circle of their professional friends on WhatsApp and do their own case studies between them – there are different ways to make it happen.”
It comes down to making sure you’re serving your clients and serving yourself – so everyone wins.
Anna is forthright when she says sometimes new business owners may not be in the disability sector for the right reasons.
“People with disability are not cash cows. You need to commit to person centred practice that is unique to each participant,” she says.
“The other thing is, just because a participant has specific funding doesn't mean you have to use it all. If you have a client who is funded for 12 hours a day of support, but you notice they only need eight hours of support, communicate that. You can offer capacity building with the extra hours or keep some for other stuff they might like to do.”
Peter says clinic owners need to ensure that they respect their own working time in the way they would respect their patient’s time.
“For some business owners, when they are working as a practitioner, their time management is fantastic, they’re focused entirely on the client. But when they’re working as a business owner, they can’t organise and prioritise time as well. The same respect and attention you give to the client you need to give to your business,” he says.
Making the switch from practitioner to clinic owner also requires a mindset shift, Peter adds.
“You need to understand that your role changes from supporting your clients to also supporting and helping your team," he says.
"Working as a clinician, you are one to one, you see the results in front of you, with happy people and making a genuine difference. But, as an owner, it often becomes about dealing with team members who need support to work through challenges, unhappy clients who want to speak to you etc.
“But it helps to remember: as a physio I could help maybe 60 people. As a clinic owner, with my team as an extension of me, we could help potentially thousands of people.”
