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NDIS participant's guide to cancellations

A calendar and clock.

Cancellations for appointments are annoying for everyone โ€“ but when it comes to cancellations for National Disability Insurance Scheme (NDIS) funded supports, itโ€™s important you understand both your rights and obligations.

We all have war stories about those times when โ€˜budgetโ€™ airfares turned out to be $50 more, shipping costs tipped a โ€˜cheapโ€™ purchase into a spendy one, or a public holiday surcharge added five extra bucks to the price of breakfast at the local cafe.

Youโ€™ve experienced it yourself, right?

So, you know as well as we do that hidden costs can quickly add up and burn a hole in your pocket โ€“ and they exist in the NDIS too

Over time, these added charges make a big difference to your NDIS funding, and none more so than cancellation fees!

At My Plan Manager, we look at thousands of invoices every week and we see how common cancellation fees are. Thatโ€™s why we wanted to share a few tips to help you keep them to a minimum.

NDIS standard short notice cancellation requirements โ€“ the rules about seven days versus two clear business days

According to the NDIS Pricing Arrangements and Price Limits, providers of disability support worker related supports can charge 100 per cent of the service fee for cancellations if theyโ€™re not made at least seven days prior to the scheduled start time of the agreed support.

For supports that are not disability support worker related (like physiotherapy), two clear business days' notice is required.

But โ€“ and itโ€™s a big but โ€“ providers can only apply a cancellation fee if they canโ€™t fill your appointment with another client or divert their staff member (like a support worker) to another job.

Tips for avoiding cancellation fees

Here are our top tips for avoiding or minimising cancellation fees.

1. Always read the terms of service

Before you engage a providerโ€™s services, be sure to check their terms and conditions, especially for information about how they handle cancellations. A provider should also outline their cancellation fees in their service agreement.

2. Avoid cancellations and no shows as much as possible

It may sound simple, but an easy way to avoid paying cancellation fees, is to show up to appointments at the scheduled time, and at the agreed meeting place.

Of course, thatโ€™s easier said than done when unexpected events occur โ€“ like illness โ€“ or when your support worker cancels their shift and there's no one available to take you to your appointment.

What happens if my cancellation is caused by a support worker cancelling on me?

Where it gets even trickier is when a provider cancels, which the National Disability Insurance Agency (NDIA) say they can do at any time, without penalty โ€“ even at the last minute. So, if a support worker cancels on the day of their shift and, for example, you canโ€™t attend an appointment with your Occupational Therapist (OT) as a result, you still have to pay the OT.

When canโ€™t providers charge a cancellation fee?

There are a few scenarios where providers canโ€™t charge a cancellation fee.

1. When youโ€™ve provided sufficient notice

If youโ€™ve cancelled your appointment well ahead of time (either two clear business days or seven days โ€“ depending on the type of appointment) then youโ€™ve met your obligations, and the provider canโ€™t charge a cancellation fee under NDIS rules.

The NDIS Pricing Arrangements and Price Limits says:

Cancellations can only be claimed for supports where the NDIS Pricing Arrangements and Price Limits indicate that cancellations can be claimed, and the terms of cancellation were stated in a signed agreement.

2. When the provider was able to reallocate the staff member who was going to support you

In the event of a cancellation, if the provider was able to find alternative billable work for the relevant worker, they canโ€™t charge you a cancellation fee.

This is a rule thatโ€™s more commonly broken and unfortunately it can be difficult to track โ€“ so the only way to find out if the worker was allocated to another billable task is to ask.

Of course, it can help to have a good relationship with providers, to have clear and open communication, and to know your rights and assert them.

3. Cancellations canโ€™t cover fees for costs not incurred

You canโ€™t be charged a cancellation fee for costs the provider didnโ€™t incur, like mileage.

NDIS Pricing Arrangements and Price Limits

All providers must adhere to the NDIS Pricing Arrangements and Price Limits, whether theyโ€™re NDIS-registered or not.

Importantly, if a provider changes the terms of their cancellation fees after you sign a service agreement, they either need to get your approval first, or cancel the service agreement and issue a new one. They canโ€™t charge you extra fees without your approval.

Itโ€™s also worth knowing that if a service agreement youโ€™ve consented to doesnโ€™t comply with the NDIS Pricing Arrangements and Limits, the agreement is invalid.

Cancellation fees are common in the NDIS and knowing your rights and proactively advocating for what you want and need from your providers is vital.

To set expectations, and before consenting to a service agreement, you may want to have a conversation with each provider about their approach to cancellation fees.

To help you to engage the right providers for you, we've created this checklist, which outlines what to know and what to ask.

Where service agreements do and don't apply

Here are a couple of examples of where service agreements do and donโ€™t apply:

Example 1: A service agreement has shorter notice period than the NDIS minimum

A service agreement you consented to stipulates the provider can charge a cancellation fee if you provide less than 24 hours' notice.

The agreement is acceptable because youโ€™ve negotiated cancellation terms that are better than the terms set out in the NDIS Pricing Arrangements and Price Limits.

Example 2: A service agreement has a longer notice period than the NDIS minimum

A service agreement you consented to stipulates the provider can charge a cancellation fee if you provide less than 10 daysโ€™ notice.

The terms of the agreement exceed the NDIAโ€™s maximum notice for cancellation. Regardless of what the agreement states, you canโ€™t be charged for a short notice cancellation if you provided the required notice.

What to do if a provider charges you incorrectly

Itโ€™s ok to speak up if you believe a provider has charged you incorrectly. This is your consumer right.
You may wish to speak with them first to see if they can put things right or, alternatively, you can ask your support coordinator or local area coordinator to do it for you.

If you canโ€™t resolve billing disputes with a provider, you can also contact the NDIS Quality and Safeguards Commission.

If youโ€™re a My Plan Manager client and you think a provider hasnโ€™t charged you correctly, be sure to let us know, and we can cancel the invoice.

We encourage our clients to sign up to receive SMS notifications from us. These alert you to whoโ€™s claiming from your NDIS funding and how much, so you can contact us straight away to query invoices as theyโ€™re received.

If you donโ€™t currently receive SMS notifications from us, you can switch them on at any time by calling us on 1800 861 272 from 8am-5.30pm (SA time), Monday to Friday.

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