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.”
