Name: Provider Choice
Address: 276 Devonshire St, Surry Hills, NSW, 2010, AU
Telephone: 1300 776 246
Price range: @

How do I endorse Provider Choice as a Plan Manager in the PACE portal?

With the new NDIS PACE system, you need to first endorse any plan manager you want to work with. This just means you have to call the NDIS (on 1800 800 110) to tell them who your new plan manager is. You can also do this with your Local Area Coordinator (LAC). We’ve written this script to help your call, pre-filled with important details about Provider Choice.

Hi there.

My name is [Your Name], and I am a [participant / plan nominee] in the NDIS. My NDIS number is [Your NDIS number].

My NDIS plan is on the new PACE system. This means that I have to endorse my plan manager by speaking with you. Could you please endorse Provider Choice Plan Management as my plan manager for my NDIS plan. (If asked, Provider Choice’s provider registration number is 4050041521).

I want to endorse Provider Choice from the date my plan started, which is [Your NDIS plan start date].

Can you please confirm this has been completed and that Provider Choice will be able to begin services for me straight away? (They should be able to tell you “yes.”)

‍Important tips!

Make it clear to the person on the phone that your NDIS plan is on the new PACE system.
Make sure that they confirm that Provider Choice Plan Management is being endorsed by telling them the provider number (4050041521).
It is crucial to begin the endorsement from your plan’s start date. This makes sure all invoices that fall within your plan dates can be processed.
Stay on the phone until they have told you the endorsement is finalised. It should be completed in one phone call. They should not tell you that it will take time to complete this - the endorsement process is instant.

Have questions or would like someone to talk you through this process? You can call the NDIA on 1800 800 110. We’re also here to help - you can contact our Plan Management team on 1300 776 246.

How do reimbursements work?

As well as paying providers directly, there may be times where you make payments for goods or services up-front and require reimbursement from Provider Choice.

Participants would have received the Provider Choice Reimbursement Form. This form is to collect details to enable participants to claim reimbursement for approved products and services that you have paid for out-of-pocket.

We will keep your details on file so that when you send through reimbursement requests, we have your details ready-to-go and can ensure your reimbursement can be made promptly.

‍

What do I need to send through when I have a reimbursement request?

It’s important that when you are sending a reimbursement request that this is either:

A tax invoice which reflects payment being made and $0.00 owing, or
A receipt of payment

In order for us to process the reimbursement the receipt must clearly show:

the service dates
the service provided
the cost of the service
the provider's ABN
‍

Where do I need to send my reimbursement request?

Participants can send receipts to invoices@providerchoice.com.au for processing.

If you can include the word ‘Reimbursement’ in the email subject line or in the body of the email, this will help us to easily identify your request as a reimbursement.

We will use the information that you provide to submit a claim to the NDIS for us to then reimburse the funds into your nominated bank account (per your Provider Choice Reimbursement Form). Once we make payment, you will be sent a remittance advice via email with details of the payment for your records.

‍

Invoicing for PACE participants

What is PACE?

PACE is the NDIA’s new computer system. It will eventually replace the Agency’s existing Customer Relationship Management (CRM) system. This new system is designed to improve connections between participants and the NDIS. These improved connections will allow NDIA staff and partners to have more time supporting people with disability to access supports.

PACE plans have already started to be rolled out, with many Provider Choice participants now having PACE plans.

Instead of having Service Bookings, participants will endorse their chosen Plan Manager under the PACE system. Endorsing a Plan Manager will give the provider access to the funding under that plan from the date of endorsement only.

The endorsement date is not necessarily the start date of the participants plan. If this is the case, the participant/nominee will need to contact the NDIS to adjust the endorsement date to the start date of the plan in order for us to access funds for the entire plan period.

Provider Choice needs to be recorded as the participants ‘Plan Manager’ in order to process invoices.

If we have been unable to process your invoice due to not being listed as a Plan Manager, this means that the participant has not endorsed Provider Choice as their Plan Manager, or we have been endorsed incorrectly.

Sometimes we are endorsed under ‘My Provider’, however this does not endorse us as a Plan Manager. We need to be recorded under the ‘Plan Manager’ role in order to access the participant plan to process invoices. Sometimes we haven’t been endorsed at all.

‍

You will need to contact the participant, nominee or Support Coordinator to discuss your invoice if:

Provider Choice is not recorded as a ‘Plan Manager’ on the participants PACE portal
the date of services on the invoice is prior to the date of endorsement
the category of services provided on the invoice is not included in the participants PACE plan (you can find out more about the updated PACE categories here: How have funding categories changed under PACE?)

‍

We will email you to advise if any of the above applies to your invoice, so that you can take the next steps.

You can go to the NDIS Website My providers for further information.

‍

What happens if I invoice under a retired/deactivated line item code?

The NDIS will sometimes update the NDIS Pricing Arrangements and Price Limits support catalogue and make changes in line with price regulation and NDIS updates. These changes can include:

changing/updating support item codes
retiring/deactivating certain support items
consolidating multiple item codes into a singular code

In doing so, codes can become outdated and not in line with the NDIS Pricing Arrangements and Price Limits.

We are unable to claim using a retired or deactivated line item code as these requests are rejected by the NDIS. If you invoice using a retired or deactivated line item code, we will email you to request an amended invoice

You can refer to the NDIS Pricing Arrangements and Price Limits which includes all current codes, descriptions and price limits for active support items.

My invoice cannot be processed due to the services being outside of the plan dates - what does this mean?

All NDIS plans have a start and end date. Plan Managed participants have choice and control to choose who their Plan Manager will be at any time in their plan.

If a service you have provided is outside of the dates that we were the chosen Plan Manager for the participant, we will be unable to process these dates on the invoice.

You will need to speak with the participant, nominee or Support Coordinator to confirm how to claim your invoice. Some possible scenarios are:

the funds are NDIA Managed or Self-managed on the date of service
the service date is within a previous NDIS plan where a different Plan Manager managed the funds
the participant has changed Plan Managers mid-plan, and the services will need to be claimed from the new Plan Manager who now holds the plan funding for that date*

*Please note that when a participant changes Plan Managers mid-plan, all funds are released from the Service Booking for the new Plan Manager to create a Service Booking for the entire plan period.

For example, Plan Manager A is the Plan Manager for John Doe 02/02/2023 - 01/02/2024. On the 12/05/2023 John Doe moves to Plan Manager B. Plan Manager A will release all funding for John Doe, and Plan Manager B will create a service booking with the remaining funds for the full plan period 02/02/2023 - 01/02/2024 (not just from the 12/05/2023). Plan Manager A will no longer have access to process any invoices for John Doe. All invoices will need to be directed to Plan Manager B, regardless of date, for the remainder of the plan.

‍

Why can't I invoice for future-dated services?

Plan Managers can only make a claim once a support has been delivered, and an invoice has been raised. We are unable to process an invoice with a future-dated service date.

If we receive an invoice with a future-dated service, we will email you to advise that we are unable to process your invoice. You will need to send through your invoice once the service has been delivered and the details of the invoice are accurate per the services delivered.

Per NDIS guidelines, prepayment is generally not permitted for supports or services. For some higher cost supports, you may be able to claim prepayment before the support is delivered.

Prepayments without written approval from the NDIA can only be claimed in the specific circumstances outlined in the NDIS Pricing Arrangements and Price Limits under ‘Prepayments’ or you can contact the NDIS on 1800 800 110 for further information.

What you need to know about refunds

I need to organise a refund. What’s the process?

If you need to refund an amount to Provider Choice, please use the below account details

Acc Name: TMBJCS Pty Ltd
BSB: 082356
Acc No.: 917043707

Please quote the invoice number as reference for the payment and send us the remittance once payment is made to invoices@providerchoice.com.au.

Why don’t you accept credit notes?

Unfortunately, we can’t hold funds for participants. Our role as a NDIS Plan Manager is to process payments for invoices received for services that have occurred, or purchases that have been made. Each invoice must be submitted to the NDIA using the service date(s), line item(s) and amount(s) to truthfully represent the services/items received/purchased.

Participant NDIS plans have a start and end date and are divided into multiple categories where funds are not transferable. Invoices that have been claimed to the NDIA for a specific service date, line item and amount must be for a service/item that was actually received/purchased on that date which matches the details of the claim.

For example, if a credit is retained by a provider for a cancelled Support Work service for Saturday 9th December 2023 and then applied to a future invoice with a service date of a weekday 21st February 2024, the NDIS claim for Saturday 9th December 2023 no longer matches the dates, services and item that was delivered. In addition, as plans end and change, there are risks of invoices being claimed and paid from the incorrect plan.

These claims would no longer be NDIS compliant.

To remain compliant, if there are changes to the services delivered or goods received, we require a refund so that any claimed funds are returned to the participants Service Booking.

I have amended an invoice after it was paid. Can I only refund the balance?

Yes, we now accept partial refunds.

My invoice has been partially paid due to being over the price cap/limit - what does this mean?

As part of the National Disability Insurance Scheme (NDIS), there is price regulation in place to ensure that participants receive value for money in the supports that they receive. These regulations are referred to as price limits/price caps.

NDIS Pricing Arrangements and Price Limits are published by the NDIS to assist participants and providers in understanding the price limits which apply. It also provides information on the current (and previous) price limits for each support item and indicates which claim types (travel, non-face-to-face, etc.) apply for each price-limited support item.

You can find the NDIS Pricing Arrangements and Price Limits on the NDIS website.

Price limits are the maximum prices that providers can charge NDIS participants for specific supports, and we are unable to claim over the price limit. Different price limits apply depending on the location of the participant, and if the NDIS considers them to be in a Standard, Remote or Very Remote location.

If GST is applicable to a support, the price limit is inclusive of GST.

Please ensure that all invoices fall at or below the relevant price limit to ensure that invoices can be processed in full. When an invoice is issued with a unit price above the relevant price limit, we will send you an email to let you know that the invoice has been partially funded by the NDIS up to the relevant price limits for the dates on the invoice so that you are aware.

My invoice cannot be processed due to the category not being available - what does this mean?

There are three ways that a category of funding can be managed within a participants NDIS Plan:

Self-managed: the participant, or their plan nominee or child representative, manages their own funding and pay their providers directly

Agency-managed: the NDIA manage the funding and pay providers.

Plan-managed: A registered Plan Manager (Provider Choice) manages the funding and pays your providers.

‍

We are only able to claim for services provided that fall into Plan Managed funding categories.

If we are unable to process an invoice due to the category not being available, this may mean:

the category invoiced is not included in the participants NDIS plan
the category invoiced is Self-managed or Agency-Managed

It is best to speak with the participant, nominee or Support Coordinator to confirm the available plan funding and determine if the funding category is available and how it is managed. Plan Managers are unable to discuss a participant’s available funding with providers.

If an alternative Plan Managed category can be used for the service provided, you can amend the invoice and resubmit for payment to invoices@providerchoice.com.au.

You can find the NDIS Pricing Arrangements and Price Limits on the NDIS website which includes all current line item numbers and supports to assist you when invoicing for NDIS participants.

‍

My invoice cannot be processed due to insufficient funds - what do I do now?

There are times when we will be unable to process your invoice (either partially or at all) due to insufficient participant funds. This means that the participant you have invoiced for does not have sufficient funds remaining under the invoiced category/line item to claim the invoice.

There are two options:

If there is an alternative line item you can invoice for, please amend the invoice and send it to invoices@providerchoice.com.au so that we can reprocess the outstanding balance. If you are sending us an amended invoice - please ensure the invoice number is not changed so that we know this is an amendment.
‍
If you’re not sure which line item to use, you can discuss this with the participant/nominee or Support Coordinator. Plan Managers are unable to discuss a participant’s available funding with providers.
If there is no alternative line item, we can submit the invoice to the NDIS as a manual payment request. We can only submit this request once the relevant NDIS plan has ended, and it is important to note that payment is at the discretion of the NDIS.
‍
In order to do this, the invoice will need to be amended to show the outstanding balance only (if partially paid), and will need to include all of the information found under Invoice Requirements on the NDIS website - Getting Paid. Failure to include all of this information will result in a payment rejection from the NDIS team.

If you are not familiar with NDIS pricing, the NDIS provides helpful resources for providers on their website: Pricing Arrangements.

‍

Why can’t Provider Choice tell me which support item number to use on my invoice?

A line item number is a number that lets the NDIS know the exact support type that has been provided.

Providers are responsible for ensuring that the claims for payment that they make accurately reflect the support delivered, including the frequency, volume and type of support (support item number). Plan Managers are unable to discuss a participant’s available funding with providers. You can refer to the NDIS Pricing Arrangements and Price Limits which includes all current codes, descriptions and price limits for active support items.

As a Plan Manager, when making claims to the NDIS Provider Choice must include the relevant NDIS support item number for the services provided on the invoice.

This information (the description of the service and, where possible the specific support item number) being included on the invoice ensures that the claims we are making on your behalf are being allocated against the correct funding of the participant that you are supporting, and are in line with the funding provided in their NDIS plan. It also ensures that all required information is available on the invoice in the case of an NDIS audit of any claims.

Plan Managers are not in a position to be able to support providers on which line item is appropriate for the supports being provided, but if you do need some support choosing the best support item you can contact the participant, nominee or Support Coordinator to discuss the available plan funding, or contact the NDIS on 1800 800 110 for assistance.

‍

What information do I need to include on my invoices?

Invoices with all of the following information meet the NDIS invoicing requirements and will allow our team to prioritise these invoices, ensuring faster payment and reducing any cause for delay.

‍

Your business and invoice information

Provider name
Australian business number (ABN)
Payment details (BSB and account number)
Email for remittance
Unique invoice number to avoid duplicate payments
Date of issue

‍

The participant’s information

Participant’s full name
Participant’s NDIS number ‍

‍

The details of the support provided

NDIS support item number (as listed in the NDIS Pricing Arrangements and Price Limits)
Brief description of the support provided
Rate and quantity for each support provided
Date and hours for each individual support item delivered
GST component if applicable (most services are GST free)
* Please note: If GST is applicable to a support, the price limit is inclusive of GST
Total amount due

‍

Having the right information in the best possible format will ensure your invoices are processed quickly and meet the NDIS invoicing requirements. The ideal invoice includes all the information mentioned previously.

‍

The best formatting for key information as per the below invoice example:

Participant NDIS number: A number with 9-digits and no spaces in between.
Support date/s: An individual date of when each support was delivered is provided per line item and not as a date range.
NDIS support item number: A number formatted as per the NDIS Support Catalogue for the relevant support provided is included in the description for each line item.

‍

What you need to know about invoicing for participants who are Plan Managed