A Guide: How your providers get paid when you are NDIS Plan Managed

A Guide: How your providers get paid when you are NDIS Plan Managed

Have you ever called up and asked about the progress of an invoice you have submitted for payment to your NDIS Plan Manager, been given a response that it’s been processed and will be paid soon and thought, I don’t know what “processed” means!? Well, you are not alone! It can be hard to keep up with the language the NDIS and NDIS providers use.

We want to break down the process of invoices coming to your NDIS Plan Manager and then your providers being paid. Keep in mind the below is specific to how we work at Pathways to Care but this would be very similar to other Plan Management providers’ processes.

The more you can understand how your providers work and get paid the better equipped you are to navigate the NDIS system. So below we have a step-by-step guide to understanding the process.

1. A provider invoice is sent to us via email. For the quickest possible processing time, invoices should be sent as PDFs, containing the email subject line “invoice”.

2. The invoice is then loaded into our Plan Management software program. This is done automatically if the invoice comes through as a PDF. If it comes through as any other document, the invoice must be manually placed into the system.

3. Once the invoice is in the system it is processed. The processing step includes the invoice being checked over to make sure there aren’t any errors, incorrect line items included for the service listed and the dates are correct and match the price being charged.

4. The invoice then needs to be approved. If a participant has invoice approval set up, it will need to be approved by them through the dashboard. Invoices that aren’t approved within 3 days automatically get approved by the system on the 4th day, so payment isn’t delayed. If there is an issue with an invoice the participant can put a hold on approval, and this will be looked at by the Plan Manager. If the participant doesn’t have invoice approval the Plan Management team does the approval if everything is correct.

5. Once the invoice is approved it is then sent to the NDIS by us, through PRODA (the NDIS system). This process is done, every day at 3 pm.

6. It then takes 12 hours for the NDIS to release funding to us. Invoices can be rejected by the NDIS, which means funds are not released. Rejection can happen for a number of reasons, for example, funding might have been exhausted for a certain budget, but an invoice has been claimed under that budget. If an invoice does get rejected, we must follow up and correct the issue, which delays the payment process.

7. The final step is us making payment to the provider. Provider payments are processed by us every day before 12 pm. The time it takes for the money to get into a provider’s account depend on their bank. Payment is received by a provider within 1-3 business days. A remittance notice is sent to providers once we have made payment.