10 years. Time flies!
In 2014 – while working at the National Disability Insurance Agency – our founder, Claire Wittwer-Smith, created the concept of National Disability Insurance Scheme (NDIS) plan management, and brought the service to life.
With a background in special education and disability policy, she saw the newly-launched NDIS had the potential to transform Australia’s disability landscape by supporting people to self-determine their hopes and plans for the future.
With the advent of the Scheme, people with disability had more choice and control over the supports and services they accessed, and the freedom to map their own paths towards the lives of their choosing.
But…the NDIS was also complex, and participants needed support to get to grips with the new world of funding – and what it meant for them.
And so, My Plan Manager was born.
A decade in the game has made us reflect on our journey – and those who’ve been there from the start, as well as those who’ve joined us along the way. As we wrap up our 10th year of service in the NDIS, we want to shine a light on those who’ve made it all possible – our incredible clients and the wider disability community – and thank you for inviting us into your lives.
We hope you enjoy these 10 client stories every bit as much as we do!
Jasmine is a caring person who’s taking steps towards her future. She volunteers as a barista at the Salvation Army, helps tutor her younger, home-schooled siblings, and assists her mum Katrina who’s a participant in the National Disability Insurance Scheme (NDIS) too.
She enjoys drawing art on her phone, taking care of her pet finches and canaries, and nurturing her brood of Araucana chickens and encouraging them to lay their blue eggs (the ones that remind her of Easter).
Jasmine’s thriving at work, where she’s building new skills, and says her employment journey started by chance.
“One day, my support worker and I were out and about, and we came across a Salvos store. We went in and asked if they were looking for a volunteer, and they said yes,” says Jasmine. “That led to my work as a barista.”
“The people there are really friendly and there’s a stack of mini jobs – like sorting clothing and goods that people bring in and serving coffee at the café to customers and volunteers. Any donated items that aren’t intact or can’t be used are sent to Africa to make rugs.”
Jasmine sees her support worker, Sarah, every week. Sarah and Jasmine are a great fit – they like going to the beach, bowling, and visiting the library, and they both enjoy working out too.
They’re currently working together to prepare Jasmine for her future as a driver, starting with learning the road rules and getting Jasmine ready to take the test for her L plates! Hitting the open road will mark a big milestone for Jasmine and her journey towards independence.
Together with her mum, Jasmine's been exploring NDIS therapies and providers – looking at the supports available to help her achieve the goals she’s set for herself.
“The work I’ve been doing has been building my social skills and confidence, and once I’ve built them up a bit more, I’ll explore the next step in paid employment,” says Jasmine. “I’m currently looking at different barista courses.”
And when she can actually squeeze in a break, Jasmine likes to tuck into a pizza and catch up on her favorite reality TV shows.
It’s good to see Jasmine can take that time out to help her reset and thrive even more!
Finished reading? Check out Alan's story here.
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 [email protected] or call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday.
30 September 2024
Fees. Annoying? Yes. Essential? Sometimes!
In the National Disability Insurance Scheme (NDIS), fees are extra charges providers can pass on to participants when providing supports and services.
While very few people will enjoy chunks of their funding being eaten by fees, they're often essential for providers to charge so they can maintain business operations and service the disability community.
Amongst all those numbers and codes on your invoices, how can you tell which fees are legitimate and which aren't?
As a starting point, check this list of the top five ‘extra’ fees that can be charged by operators in the Scheme.
An establishment fee is a once-off cost providers can charge you if they’re going to deliver more than 20 hours of personal care or community participation support to you each month – and if they’re going to support you for three or more consecutive months.
They can only claim the fee once, so keep that in mind.
Providers can charge you for the things they do when you’re not around – things that make sure you can participate in group or centre-based supports.
Examples of the ‘non-face-to-face’ tasks that can attract a fee in the NDIS include:
NDIS providers are responsible for the costs associated with their own administration (e.g. invoicing), and for training, upskilling and supervising their staff. That means you can’t be invoiced for these activities.
A capital centre fee helps providers meet the costs of running and maintaining their physical premises.
The fee can be charged at a per participant/per hour rate if high intensity daily personal activities, specialised supported employment, or group and centre-based activities are funded through your Assistance with Social, Economic and Community Participation budget – and if those supports are delivered to you at the provider’s premises.
If supports are delivered onsite as well as in the community – but the premises are always available during the period of support delivery – providers can still claim the full centre capital fee from your funding.
Your NDIS budget can be charged for the cost of travel when a provider spends time accompanying you out in the community, travels to you, or has to pay travel costs such as parking fees or tolls.
The National Disability Insurance Agency (NDIA) doesn’t determine how much providers can charge for travel – and that means that if your provider makes you aware of their fees and you consent to them, they can charge you any amount (once agreed).
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.
If a provider travels to you (e.g. for at-home therapy) and charges the maximum hourly rate allowed, adding travel to the price of your session means costs can quickly add up. That’s why it’s good to consider local providers try negotiating a reduction or elimination of travel charges.
Always request a quote before committing to services and be sure to ask about travel costs.
Cancellation fees are common in the NDIS, and there are specific rules about what participants can and can’t be charged. Before you engage a provider, check their terms and conditions for information about how they handle cancellations.
Providers of disability support worker-related supports can charge 100 per cent of the service fee for cancellations if they’re not made at least seven clear days prior to the scheduled start time of the agreed support.
For supports that are not disability support worker-related (like therapy), participants need to provide two clear business days’ notice of a cancellation.
Importantly, providers can only apply a cancellation fee if they can’t fill your appointment with another client, or if they can’t divert their staff member to another job. You also can’t be invoiced for costs that weren’t incurred, like travel costs.
Good communication between you and your provider is key.
Check out our participant’s guide to cancellations for more information.
Fees are intended to recover financial costs to a provider, and they need to meet the requirements of the NDIA.
If you’re ever unsure of what a charge is for, always check with your provider in the first instance – and if you believe you’ve been incorrectly charged, just let them know.
Below are some activities and costs the NDIA says providers can’t charge you for:
You also can’t be charged an exit fee when you leave a provider’s service – but if you end a service agreement early, you may be charged a cancellation fee (depending on the terms set out in the agreement).
For more information about NDIS fees and charges, give us a call on 1800 861 272 from 8am-6pm (SA time), Monday to Friday.
3 September 2024
Becoming a National Disability Insurance Scheme (NDIS) participant can be life changing. It means you’ll finally have access to funding to pay for supports to live life the way you want to.
It’ll come as no surprise then that, following acceptance into the Scheme, you may feel a flurry of relief, excitement and anticipation – at least, that’s what we hear from many of our clients!
And those positive feelings don’t need to give way to confusion or worry about what to do next, because we’ve gathered the information you need to know from the beginning of your NDIS journey, so you can get the most out of your NDIS plan.
Yes, the Scheme is complex, and yes, there’s lots to learn. But we’re here to help! Together, we can set you up for success.
Here’s what you need to know.
Firstly, as an NDIS participant, you have rights – and you should know about them.
All providers and workers are bound by the NDIS Code of Conduct, and they must respect and uphold your right to safe and quality supports and services. You can access the Easy Read version of the NDIS Code of Conduct here.
As for the National Disability Insurance Agency (NDIA), it has a Participant Service Charter that explains what you can expect from it. For example, it includes a Participant Service Guarantee, which sets out the timeframes the Agency must adhere to when making decisions about things like Scheme access, plan reassessments, reviews, and nominee changes. We’ve written more about that here.
You’ve got your plan, and you’ve got your funding… but how exactly do you spend it? The answer to that will be as unique as you are, and a plan manager (like My Plan Manager) can help.
Together – through a budget conversation – we can look at the length of your plan, the categories and budgets included in it, the funding you’ve got, the supports you need, and how often you want to access them. From there, we can set money aside to cover your costs, and create a visual picture of how much you can spend in different areas across the lifespan of your plan.
If you have a support coordinator, they can join the conversation too, or you might like to involve a plan nominee, family member or friend. The more people in your support network, the better!
In the meantime, here’s a quick guide to NDIS funding.
Put away the pen and paper, and close that Excel spreadsheet, because we’ve got the tech to help you keep track of your plan spending with ease.
A digital platform that displays a clear, convenient, real-time picture of your NDIS budget and gives you more control over your plan funding and spending, our secure client portal can be accessed via your computer or on your mobile phone through an app.
It’s available to all My Plan Manager clients, and you can grant access to others (like your support coordinator and family members) if you want to.
Through the client portal (web and app) you can:
You can also contact us directly through the mobile app by pressing ‘click to call’ or by requesting a call back.
A service agreement is an agreement between you and your provider that makes it clear what you have both agreed to. Usually, a service agreement will cover:
When you supply service agreements to us, we can set aside the service fees outlined in the agreement so you’ll always have enough money to cover your supports.
If you catch public transport, you’ll know there are ‘on-peak’ and ‘off-peak’ times that dictate the price of your fare. That’s similar to provider rates in the NDIS.
Rates can vary across weekdays, weekends and public holidays – as well as between mornings, afternoons and evenings. So, it usually costs less to access supports on a weekday morning than it does on a Saturday, Sunday or public holiday evening.
Maximum provider rates are set out in the NDIS Pricing Arrangements and Price Limits, which you can find here.
Inflated pricing in the NDIS is sometimes called ‘price differentiation’ or a ‘twin pricing regime’. It occurs when a provider charges a participant more for a product or service than they’d charge a person who’s not in the Scheme.
To make it fairer for participants, the NDIS Quality and Safeguards Commission is making providers more accountable by homing in on price differentiation and releasing a number of new pricing rules – meaning when you’re charged a higher rate because you’re a participant in the NDIS, you can contact the NDIS Quality and Safeguards Commission at [email protected] to let them know.
The two most common unexpected fees that catch participants out are transport costs and cancellation fees – but now you know about them, you may be able to avoid them.
Providers can charge your NDIS budget for the cost of travel when they spend time accompanying you out in the community, or when they travel to you or incur expenses, such as parking fees and tolls. You can reduce travel costs by accessing local providers, and by arranging less frequent appoints that run longer.
Cancellation fees can be trickier to avoid, but here’s our ultimate guide to them. The guide includes this tip – that cancellation fees only apply if your provider can’t fill your appointment with another client or divert their staff member to another job.
Unfortunately, filling out paperwork doesn’t stop with your Access Request.
There are several key documents that you or your providers may be asked to deliver at one stage or another of your NDIS journey to ensure you keep receiving the funding you need.
For example, if your support needs change, your occupational therapist may be asked to supply a functional capacity assessment, a provider report or a letter of recommendation. And you may have the opportunity to supply a lived experience statement or a carer impact statement – learn how to write those here.
The NDIA will schedule a check in with you every year to explore how you’re going with your plan. A check in can take place face-to-face, by phone or online – and you’re welcome to include a family member, support coordinator or someone else who supports you.
During your conversation, an NDIA representative may ask you how you’re going with your goals, how you’re using funded supports in your plan, and if you have any questions.
If you’d like support with understanding and managing your NDIS funding, we’re here to help. You can email us at [email protected] or call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday.
Most people know the National Disability Insurance Scheme (NDIS) funds services like support work and allied health therapies, but did you know it can also cover the cost of assistive technologies and other products that make life just that little bit simpler?
Known as ‘consumables’, these items help people to manage their disability-related needs – and they can include anything from specialised clothing and equipment for eating and drinking, to non-slip bathmats, sensory products, and writing aids.
‘Consumables’ is also the name of a category of NDIS funding that a large number of participants have included in their plans. It sits under the Core Supports budget, has a good degree of flexibility, and includes thousands of products. Among the most commonly claimed items are:
With a huge range of products available to support people with disability to lead more independent lives, we’re lifting the lid on consumables to help you put your NDIS funding to best use. And better still, we’re giving you the inside scoop on how to ensure trouble-free processing of payments for every item you order.
Your Core Supports budget is flexible, meaning that even if you don’t have consumables funding specifically included in your plan, you’ll usually be able to claim for low risk items under $1500 without allied health reports or other documentation – if the products are related to your disability and not funded by a different government service.
Low risk means there’s little chance of harm when the product is used in everyday life, it isn’t something you need professional advice in order to use safely, it doesn’t need customisation or modification, and it’s available for sale to the general public.
If you’re not sure if you have consumables funding – or if you’re still not clear about whether you can claim for a purchase under $1500 – answering yes to the questions below is usually a good indicator that your invoice will covered by the NDIS.
If you answered ‘yes’ to all of the above, it’s likely the product you’re wanting to buy will be approved.
But before you make a purchase or place an order, you also need to find out if the support is one that should be funded by another government service (e.g., dental, health or hospital services, education, housing and public transport).
The NDIS will fund some supports, such as disability-related health services, where they relate directly to the participant’s disability and where that disability impacts their daily life. But before you commit to buying, it’s always best to check whether a payment will be processed, so give us a call or get in touch with the National Disability Insurance Agency (NDIA).
If the consumables or assistive technology you want to buy aren’t under $1500 – or if the item you want isn’t considered to be low risk – there are several other NDIA rules and requirements you’ll need to address, and you may need a letter of recommendation from an allied health provider as well.
Allied health providers include occupational therapists, speech pathologists, physiotherapists and podiatrists – professionals who provide services like diagnosis, treatment, support, and rehabilitation.
It’s best to speak with your plan manager, support coordinator or NDIA partner to find out whether you have the funding you need – and to better understand the Agency’s requirements – before you make any purchases.
We know – sometimes a letter of recommendation can cost more than the item you want to purchase, and that can leave you scratching your head in wonder at why it’s even necessary. But on the other side of that debate are the rejected claims and invoices from participants who didn’t take the advice of the professionals who support them.
Your NDIS funding is precious, and you need to make every dollar count. That’s why many of our clients see allied health professionals for assessments and recommendations before engaging supports, commencing therapies, and purchasing products they think will help them to work towards their NDIS plan goals.
Your allied health professionals are part of your support network, and their advice is invaluable when it comes to deciding how best to build your capacity and grow your independence.
If there are consumables and assistive technology they suggest you use, ask them to explain how the products will help you to manage your disability, and ask for a letter of recommendation that explains what the support is, why you need it, and how it aligns with your goals.
This approach means that whatever you spend your funding on will truly add value to your life, and in addition to putting forward a professional recommendation to evidence the reasons for the purchase, your allied health professionals will also develop strategies and plans to help you use it.
As an example, if an NDIS participant has difficulty with sensory stimulation on public transport, their occupational therapist may recommend strategies to manage the challenges they face – such as planning trips in advance and purchasing noise cancelling headphones to wear when travelling. Then, the therapist will include the details of the strategy and the required tools to implement it in their letter of recommendation to the NDIA in support of the purchase of the headphones.
If you’re unsure if the NDIS will fund a particular item you want to claim, it’s best to have a conversation with us. We can advise you if the NDIA is likely to accept the claim or ask for more information.
Sometimes it’s difficult to understand the NDIA’s decisions about funding – decisions the Agency makes based on a wide range of factors, such as a person’s disability support needs, their living arrangements, and the availability of informal supports.
We explain more about the NDIA’s reasonable and necessary criteria here.
If you have any questions about consumables or using your NDIS funding, we’re here to help. You can email us at [email protected] or call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday.
Are you a National Disability Insurance Scheme (NDIS) participant? Have you ever been given a quote for a disability product or service and wondered if the pricing is higher, simply because you’re funded for the support you’re after? If you have, you’re not alone.
In the NDIS, inflated pricing is sometimes called ‘price differentiation’ or a ‘twin pricing regime’. It occurs when a provider charges a participant more than they’d charge a person who’s not in the Scheme.
An example of this is when a basic model aluminium shower chair has two price tags: $600 for NDIS participants and $150 for everyone else. The exact same shower chair – the only difference is, one is sold as an NDIS product.
Australia’s Competition and Consumer Act makes it illegal to engage in unfair pricing, but pursuing a case of this nature can be expensive and requires substantial evidence.
That’s why the NDIS Quality and Safeguards Commission has homed in on price differentiation, and announced it's making providers accountable under new rules, which apply to goods – things you can touch, feel and see.
The new pricing rules are:
For example, a provider must not sell a shower chair to an NDIS participant for $600 and sell the same chair to a member of the broader community for $150.
For example, a provider cannot advertise on its website a sale price for a shower chair if it will not offer the same price to an NDIS participant.
There are countless examples of products being advertised or sold at inflated prices to NDIS participants, purely because they have an NDIS plan and funding, and the new pricing rules crack down on that.
But a twin pricing regime isn’t exclusive to products and a question that’s repeatedly asked is ‘Will these rules apply to other supports, including services?’.
At this stage, while the Commission has not extended its rules beyond products, it has said further determinations may be made in the future, including about services such as allied health or in-home supports.
What’s important to understand about services is that some people with disability have more complex requirements than other service users, and therefore providers may attach a higher price to servicing people with higher needs.
That’s why it’s more difficult to enforce a framework around price differentiation for services funded by the NDIS, but although it may take some time, the Commission had certainly indicated it’s looking at it.
If you’re considering a product or service funded through your NDIS plan, be sure to shop around.
If it’s a product you’re after, compare prices from at least two providers, if not more – and make sure your decision factors price in, along with responsiveness, customer service, reputation and other factors.
This can be harder to do with services, because unlike comparing two identical products, there are a large number of variables in relation to services – such as the experience of the provider, their location, service offering, flexibility and reputation, all of which may impact a purchasing decision and warrant paying a higher price.
For more information about the NDIS price differentiation rules, click here.
The Australian Government has also released information about the pricing crackdown, which you can read here.
Have you ever felt curious about the inner workings of My Plan Manager?
You know we support Australians to manage the funding in their National Disability Insurance Scheme (NDIS) plans.
You know we offer up-to-date knowledge, insightful advice, and personalised support.
And you know we take our values seriously – we’re kind, genuine, innovative and inclusive!
But here’s 10 things you may not know about us that’ll give you a better insight into who we are and what we do!
With a background in special education and disability policy, our founder – Claire Witter-Smith – developed the idea of My Plan Manager around her kitchen table, while working at the National Disability Insurance Agency (NDIA).
In 2014, she created value for Australians with disability by conceptualising plan management and bringing the service to life.
Her mission then stands as ours today, to create an inclusive Australia where everyone has the opportunity to reach their full potential.
My Plan Manager was the first in the market to do what we do – support people with disability to get the most out of their NDIS plans.
Today, we’re the largest and most experienced provider in the country.
Every invoice My Plan Manager processes undergoes 32 automated checks to ensure it’s compliant with NDIA requirements, so we can deliver a speedy, accurate payment process for clients and providers.
During the past 12 months, with the support of our market-leading technology, we have:
Since 2020, My Plan Manager has invested approximately $15 million in technology and innovation, so we can remain agile and responsive to client needs and the disability sector’s constant change.
The average wait time for client and provider calls to be answered by My Plan Manager is less than 90 seconds.
My Plan Manager supports more than 35,000 NDIS participants across Australia.
There are more than 50,000 providers in My Plan Manager’s national network.
My Plan Manager launched the sector’s first client portal and mobile app – enabling clients to track their budgets in real time – and we have a portal for providers too.
My Plan Manager is steadily reducing carbon emissions through sustainable policies, purchasing practices, renewable energy, and carbon offsetting to support our environment and the communities in which we provide services.
My Plan Manager is fully accredited against the ISO 9001, ISO 27001 and the NDIS Practice Standards (verification). We were the first NDIS plan manager to achieve all three certifications.
Could prosthetics, hearing technology or a home modification make a meaningful difference to your independence?
The good news is there’s a National Disability Insurance Scheme (NDIS) budget dedicated to covering these items for NDIS participants, and it’s called the Capital Supports budget.
Capital Supports is designed to pay for higher-cost, specialised assistive technology, home and vehicle modifications and – in some instances – building and maintenance costs associated with Specialist Disability Accommodation (SDA). We cover the specifics about these categories and the items within them here.
An important detail about Capital Supports funding is that it’s prescriptive. That means it can only be used for the specific purpose stated in your NDIS plan (e.g., a manual wheelchair), and can’t be used flexibly (like some other funding).
Below is a simple five-point checklist to help you to work out if you need Capital Supports funding and, if you do, how you can secure it.
No one knows your support needs like you do, so if you already have an idea of a support item you’d like included in your NDIS plan, skip to Point 4.
1. Think about living in your home, and about being out in the community. How accessible are these two environments for you?
Perhaps your porch stairs are a barrier to you getting out of your home and into your garden, or maybe your vehicle doesn’t have the right set-up to transport you safely – if at all.
Consider how the environment around you presents challenges to you going about your activities of daily living and achieving your goals.
2. Research what assistive technology or home or vehicle modifications could help to reduce or remove these challenges.
From simple to innovative, there are assistive technology and home and vehicle modification solutions for every challenge. You can research solutions independently on the internet, or with the support of your support coordinator (if you have one) or local area coordinator.
The NovitaTech store is Australia’s largest assistive technology retailer, and you can browse their supports and services online here. For information about home modifications, get started by browsing this NDIS web page.
3. Assess your living options
If home modifications aren’t appropriate for your situation, there are other home and living supports available through the NDIS. They include SDA – which comes under the Capital Supports budget – and Supported Independent Living, which is funded separately to provide ongoing in-home assistance (up to 24 hours per day, seven days per week).
We explain the different types of home and living supports that are currently available through the NDIS here.
4. Get a functional capacity assessment
A functional capacity assessment evaluates a person’s ability to perform tasks and activities of daily living. They’re carried out by an occupational therapist or physiotherapist, and appropriate supports (like support workers, assistive technology and modifications) are recommended based on the results.
Your assessment and accompanying recommendations will assist you to secure the right amount of Capital Supports funding to pay for some of the supports you need.
You can submit your functional capacity assessment to the National Disability Insurance Agency (NDIA) as part of documentation to support your application to the Scheme, or during a plan reassessment, participant check in or review.
You might want to include lived experience and/or carer impact statements too.
Tip: Functional capacity assessments can be expensive, but if you currently have an NDIS plan with a Capacity Building Supports budget, you may be able to utilise funding in the Improved Daily Living category to have a functional capacity assessment undertaken.
5. Source and send quotes to the NDIA
If Capital Supports funding is pre-approved in your new plan, you’ll need to gather quotes from providers before making a purchase. Then, you’ll need to send these quotes to the NDIA for approval so funding can be released.
Get moving on sourcing quotes as soon as you can! Being proactive in the NDIS can help you to exercise your rights and leverage more funding.
If you have any questions about how to use your NDIS funding, we’re here to help. You can call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday, or email us at [email protected].
