Provider Choice

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.

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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.”)

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‍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? Call our team on 1300 776 246 and we'll walk you through it step-by-step.

How do reimbursements work?

If you’ve paid for an approved support upfront, you can request a reimbursement from Provider Choice.

Simply email your receipt or paid invoice to reimbursements@providerchoice.com.au. Once received, we’ll submit the claim to the NDIS and reimburse the funds to your nominated bank account.

For faster processing options, including how to unlock same-day processing, take a look at our guide: Reimbursements, Made Faster.

Invoicing for PACE participants

PACE is the NDIA’s new system and invoicing works a little differently.

To process invoices under PACE, Provider Choice must be recorded as the participant’s Plan Manager in the PACE portal. We can only access funding from the date of endorsement onwards.

If we’re unable to process your invoice, it’s usually because:

Provider Choice is not listed as the participant’s Plan Manager
The service date is before the endorsement date
The service category is not included in the participant’s PACE plan

If this happens, we’ll let you know what’s needed next.

For more information about PACE and provider roles, you can visit the NDIS website under My providers.

What happens if I invoice under a retired/deactivated support item number (code)?

The NDIS Pricing Arrangements includes all current support item numbers (codes), descriptions and price limits for active support items. Sometimes the NDIA will update it, making changes in line with price regulation and NDIS updates. These changes can include:

Changing/updating support item numbers.
Retiring/deactivating certain support item numbers.
Consolidating multiple support items into a singular support item number.

As a result, some support item numbers may become outdated and no longer align with the NDIS Pricing Arrangements. We’re unable to process claims using retired or deactivated support item numbers, as these are rejected by the NDIA If an invoice is submitted with an inactive support item number, we’ll email you to request an amended invoice.

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 was delivered outside the dates that Provider Choice was the participant’s nominated Plan Manager, we’re unable to process those service dates on the invoice.

In this situation, you’ll need to contact the participant, nominee, or Support Coordinator to confirm how the invoice should be claimed. This may be because:

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.

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

Plan Managers can only submit claims once a support has been delivered. Invoices with future service dates can’t be processed.

If we receive an invoice with a future-dated service, we’ll email you to let you know and ask that you resubmit the invoice once the service has been delivered or make sure the details are accurate.

Under NDIS guidelines, prepayment is generally not permitted. In limited circumstances, prepayment may be allowed for certain higher-cost supports, but this requires approval and must align with the NDIS Pricing Schedule.

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 dates, support item numbers (codes) and amounts 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, support item number (code) 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 support item number (code) 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 participant's available funding.

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 are published by the NDIA 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.

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 NDIA considers them to be in a National (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 NDIA 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?

We are only able to claim for services provided that fall into plan managed funding categories.

There are three ways that a category of funding can be managed within a participant's 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.

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 participant's NDIS plan.
The category invoiced is self managed or agency managed.

It's best to speak with the participant, nominee or Support Coordinator to determine if there's available plan funding and how it's 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. All current support item numbers (codes) are available in the NDIS Pricing Arrangements.

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/support item numbers (codes).

There are two options:

If there is an alternative support item number (code) 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.
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If you’re not sure which support item number (code) 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 support item number (code), we can submit the invoice to the NDIA as a manual payment request. We can only submit this request once the relevant NDIS plan has ended and payment is at the discretion of the NDIA.
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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 the necessary information. Failure to provide a compliant invoice will result in a payment rejection from the NDIA.

All current support item numbers (codes) are available in the NDIS Pricing Arrangements.

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

A support item number (code) is a number that lets the NDIA 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 which includes all current support item numbers (codes), descriptions and price limits for active support items.

As a Plan Manager, when submitting claims to the NDIA, 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, 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 tell providers which support item number (code) is appropriate for the supports being provided, but if you do need some support, 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 Schedule)
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 Pricing Arrangements for the relevant support provided is included in the description for each line item.

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