Plan Management – Terms & Conditions

This Plan Management Agreement will commence on the date you sign up, either online or otherwise, and continue until you give us notice that you no longer wish us to plan manage for you see ‘Ending this Plan Management Agreement’ below for more information).

This Plan Management Agreement is made for the purpose of providing plan management under the Participant’s NDIS plan.

A copy of the participant’s NDIS plan is attached to this Plan Management Agreement or has already been provided to us.

The parties agree that this Plan Management Agreement is made in the context of the NDIS, which is a scheme that aims to:

• Support the independence and social and economic participation of people with disability, and
• Enable people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports.

To be eligible for the Provider Choice plan management service, you

• are at least 18 years old;
• have the right, authority and capacity to enter into this agreement;
• will abide by the terms of this agreement and any relevant policies and rights and responsibilities of this agreement; and
• have plan management funding included (or are intending to request funding) as part of your NDIS plan.

If you are entering into this agreement as a Nominee, you:

• are at least 18 years old;
• have the right, authority and capacity to enter into this agreement on behalf of the Participant; and
• will abide by the terms and conditions of this agreement as set out for Participants.

Provider Choice agrees to provide the Participant plan management of their NDIS plan as a plan-managed member of Provider Choice (Member) according to the following process that you agree to:

• As your nominated plan manager, Provider Choice has the authority to act on your behalf to claim payment for supports provided to you from your NDIS plan and to pay these funds to providers.
• A service booking will be created for the entire value of your plan managed support budget categories through the NDIS provider portal.
• We will claim from the NDIS provider portal for funding up to the amounts specified in the support category and budget approved in your current NDIS plan. After these supports are delivered, the provider will claim payment for those supports from Provider Choice.

You agree that:

• We have no involvement or liability for charges above the unit price as prescribed in the relevant NDIS price guide.
• Any ‘gap’ difference between the invoiced item amount and the NDIS unit price for supports purchased are your responsibility to pay to the provider directly.
• Providers engage directly with the you in relation to the provision of goods and services and send your invoice to Provider Choice as your plan manager to arrange payment with the NDIS.
• Providers are responsible for the quality and actual service provision and activities as well as their own safety whilst providing services to you. They will have their own ABN and are responsible for their business activity as a business entity.
• You may be required to sign a specific service agreement to receive goods and services provided by providers.
• As part of establishing your service agreement with them, or engaging their services, please take the time to ensure that they have the relevant coverage for public liability, medical malpractice and personal injury.
• We are not responsible for ongoing payment to providers once you have ended this agreement and we are no longer your plan manager.

The Participant has nominated the Plan Management provider, Provider Choice, to manage the funding for NDIS supports provided under this Plan Management Agreement.

You agree that Provider Choice is able to deduct the plan management fees as set out in the relevant plan management support category in your NDIS plan. Provider Choice will deduct these fees from time to time for the duration of this Plan Management Agreement.

Ongoing fee deduction: Provider Choice will continue to deduct plan management fees from your NDIS plan until you end this Plan Management Agreement (see ‘Ending this Plan Management Agreement’). This means that if you have a new plan, your plan management fees will continue.

NDIS Price Guide and Support Catalogue: All our prices for plan management are in accordance with the current NDIS Price Guide and NDIS Support Catalogue for applicable services. If any of our prices are inconsistent with prices in the Price Guide, then the prices in the Price Guide will apply. Our prices will increase in line with NDIS maximums.

GST: Most of our prices do not include GST unless provided for in the NDIS Price Guide. If GST is included, it will be included in the price given to you.

As a Member, you are entitled to the Provider Choice plan management service while your membership is active. Provider Choice agrees to:

• Provide you with financial intermediary services;
• Reconcile your NDIS plan balances;
• Provide you with the opportunity to approve invoices and to rate services;
• Pay supplier invoices on your behalf;
• Process your reimbursement claims;
• Track your expenditure against your NDIS plan budget and make it available in real time;
• Provide you with monthly statements of expenditure;
• Consult with you regarding how your funds are spent;
• Assist you with purchases where appropriate;
• Assist you with provider service agreements;
• Assist you to track your progress to your defined goals;
• Provide you with access to support and coaching to help you maximise your NDIS plan;
• Troubleshoot for you;
• Connect with you via emails, phone calls and web chat;
• Offer a plan management service that maximises your choice and control and supports the life you want to lead;
• Respond to your specific requests and requirements in the delivery of your plan management service;
• Respect your decisions in accepting and determining plan management;
• Keep accurate records on the supports provided to you;
• Issue regular invoices and statements of the supports delivered to you;
• Seek regular feedback in relation to your experience with Provider Choice and listen to your feedback and resolve problems quickly;
• Communicate openly and honestly in a timely manner;
• Protect and maintain your privacy in accordance with our Privacy Policy;
• Treat you, your family and friends and any Nominees with courtesy and respect;
• Rely on the information that you provide as being true, accurate, complete and current;
• Provide plan management in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules and the Australian Consumer Law;
• Give you the required notice if we need to end this Plan Management Agreement (see ‘Ending this Plan Management Agreement’ below for more information);
• Inform you of any actual or potential conflicts of interest; and
• Discuss the provision of your services and supports at any time and review the provision of supports with you.

The Participant / Nominee agrees to:

• Provide accurate and relevant personal details necessary for the delivery of the Provider Choice plan management service (including your NDIS plan details, date of birth and NDIS number);
• Advise Provider Choice immediately if your NDIS plan is suspended or replaced by a new NDIS plan, or if you stop being a participant in the NDIS;
• Provide all information necessary to ensure your needs are understood, so the most effective service can be provided to you;
• Agree that you will not establish a plan management service for anyone other than yourself, with exception of people or businesses that are expressly authorised to establish a plan management service on behalf of members;
• Be responsible for any activity that occurs through your account;
• Be responsible for keeping your account identification and your password confidential and secure;
• Be responsible for keeping all appointments with providers and is responsible for paying any cancellation fees;
• Understand that when you activate plan management services through this agreement, Provider Choice will provide access to your NDIS financial information to those members of your Team (family, friends, providers and individuals from your support network) to whom you have given access to 'My finances' or deemed to be a decision-maker;
• Be responsible for ensuring the level of multi-party access and the accuracy of the details of your team;
• Treat Provider Choice with courtesy and respect;
• Not be discriminating, unlawful, rude, defamatory, harmful, threatening, indecent, harassing, abusive, aggressive, intimidating or offensive;
• Be honest in your dealings with Provider Choice, including in relation to your NDIS plan, your supports and services. This includes not breaking any rules of the NDIS, any other laws or participating in, encouraging or advocate any illegal activity. This includes things like if you misrepresent who invoices are for or what categories providers are in;
• Inform Provider Choice about how you wish the supports to be delivered to meet the Participant’s needs;
• Talk to Provider Choice if you have any concerns about the supports being provided;
• Give Provider Choice the required notice if the Participant needs to end this Plan Management Agreement (see ‘Ending this Plan Management Agreement’ below for more information);
• Comply with any relevant Provider Choice policies; and
• Inform Provider Choice of any conflicts of interest and do their best to avoid conflicts of interest including with family members.

We reserve the right to raise any concerning conduct or behaviour with you, your Nominee, and any family members that contact us, including if you, your Nominee or any family members are abusive or threatening towards us or any of our staff. We will seek a satisfactory resolution and we may need to discontinue our services to you and end this agreement.

Your privacy is important to us.

We collect personal and sensitive information about you in order to provide you with our plan management services, our associated services, to contact and communicate with you, to respond to your enquiries and for other purposes set out in our Privacy Policy.

Our Privacy Policy contains more information about how we use, disclose and store your information and details how you can access and correct your personal information.

By using our plan management services, you agree to be bound by the clauses outlined in our Privacy Policy https://providerchoice.com.au/privacy-policy.pdf.

You may need or wish to sign up to other Provider Choice services such as our platform and marketplace. If you sign up to these services you will be required to agree to additional terms and conditions. These additional terms and conditions apply in addition to, and at the same time, as this agreement.

Provider Choice recognises that conflicts of interest may occur when providing our services to a Participant under this agreement and when we, or a Participant or their Nominee, is using our other services, such as our marketplace available on our website. We want to ensure that a Participant / Nominee are aware and are provided with the knowledge and information to make informed choices and decisions. This includes ensuring that a Participant can choose services offered by other providers including those not on our marketplace.

In the provision of plan management services Provider Choice may use third parties, external business and a range of NDIS registered and unregistered providers. These third parties may have separate service agreements and terms and conditions. These are governed by the third party and are not the responsibility of Provider Choice.

You understand that in the provision of plan management services, you may be exposed to these third parties. It is your responsibility to accept services and Terms and Conditions of these third parties.

We do not accept any responsibility for the actions of third parties to the maximum extent permitted under applicable law.

(Limitation of Liability) You acknowledge and agree that the maximum liability of Provider Choice to the Participant and/or Nominee arising under or in connection with this agreement is limited to the total amount paid by for plan management in the six months preceding the first event giving rise to the relevant liability, to the maximum extent permitted by applicable law.

(Indemnity) The Participant / Nominee agrees at all times to indemnify and hold harmless Provider Choice and its officers, employees and agents ("those indemnified") from and against any loss (including reasonable legal costs, loss or damage to any person or property) or liability incurred or suffered by any of those indemnified where such loss or liability was caused or contributed to by the Participant and/or the Participant’s Nominee:

• breach of any term of this agreement; or
• negligent, fraudulent or criminal act or omission.

(Consequential loss) Provider Choice will not be liable for any incidental, special or consequential loss or damages, or damages for loss of data, business or business opportunity, goodwill, anticipated savings, profits or revenue arising under or in connection with this agreement or any goods or services provided by the Provider Choice, except to the extent this liability cannot be excluded under the Competition and Consumer Act 2010 (Cth) or any other applicable law.

CHANGES TO THIS PLAN MANAGEMENT AGREEMENT
If changes to the supports or their delivery are required, the parties agree to discuss and review this Plan Management Agreement. The parties agree that any changes to this Plan Management Agreement will be in writing, signed, and dated by the parties. This may be done as an attachment to this agreement.

Should either party wish to end this Plan Management Agreement, they must give a minimum of 30 days’ notice – either written or verbal, or such longer period as is adequate to enable the Participant / Nominee to find an alternative plan manager to deliver the support services.

If you require a longer period to find an alternative plan manager, and we remain your plan manager, you will still need to pay us any fees for plan management until you find an alternative plan manager.

If you or Provider Choice breaches this agreement, the requirement of notice may be waived by the other party.

If you have any problems or questions about our plan managing or you wish to give us feedback, please contact us using the contact details on the first page.

We will investigate any complaints and provide you with a written response (which could include email) as soon as we can and normally within 30 days from the date you first contacted us.

If you are not satisfied or don’t want to talk to someone from Provider Choice you can contact any of the agencies below: