Navigating the NDIS: A Comprehensive Guide to Working with Providers
When it comes to the National Disability Insurance Scheme (NDIS), understanding how to work with providers is essential for accessing the right supports and services to meet your disability needs. This blog post will cover what a provider is, how to find and choose your providers, changing your providers, and when you need to inform the NDIS about your providers.
What is a Provider?
A provider is a person, business, or organization that delivers NDIS-funded supports and services to participants. As a participant, you are responsible for choosing the providers you want to work with. It’s important to find the right providers who can meet your specific disability needs and help you achieve your goals.
Registered and Unregistered Providers
There are two types of providers within the NDIS framework: registered providers and unregistered providers.
- Registered Providers: These providers are regulated by the NDIS Quality and Safeguards Commission. They must meet strict conditions regarding the quality and safety of their services and cannot charge more than the NDIS Pricing Arrangements and Price Limits, which are available on the NDIS website.
- Unregistered Providers: These providers are not regulated by the NDIS Quality and Safeguards Commission and can set their own prices, which may be above or below the NDIS price limits. However, all providers must adhere to the NDIS Code of Conduct, which is detailed on the NDIS Quality and Safety Commission website.
When You Must Use Registered Providers
You are required to use registered providers for:
- Any parts of your funding that are agency-managed
- Specific supports, including plan management, behavior support, and Specialist Disability Accommodation (SDA)
For other supports, if your funding is self-managed or you use a registered plan manager, you can choose either registered or unregistered providers.
Plan Managers, Support Coordinators, and Recovery Coaches
You may have funding in your plan for a plan manager, support coordinator, or recovery coach. These providers help you manage and utilize your plan. Remember, you have the same choice and control when working with these providers as with any others. It is crucial to find a provider that suits your needs and agree on how you want to work together.
Finding and Choosing Providers
The NDIS offers a Provider Finder tool on their website to help you locate registered providers in your area. Additionally, you can research providers online or seek recommendations from friends, family, support groups, or disability associations. If you need more support, you can talk to your NDIS contact, support coordinator, or recovery coach. While the NDIS cannot recommend specific providers, they can inform you about the different providers available in your area.
It’s advisable to speak with providers before deciding to work with them. The NDIS website provides guides to help you determine if a provider is a good fit for you.
How Much Should You Pay for Your Supports?
Providers set their own prices, so it’s important to consider the costs when choosing your providers. Generally, providers should not charge you more than they charge others for the same support. If they do, they need to explain why. You can negotiate prices with your providers before agreeing to work with them. The NDIS sets price limits for many supports, which is the maximum amount registered providers can charge. Unregistered providers can charge less or more than these limits.
Making a Service Agreement
Before starting work with your providers, the NDIS encourages creating a service agreement. This document records what you and your provider have agreed upon, such as the supports provided, duration, and how you can change or end the agreement. Work together with your provider to create a mutually agreeable service agreement. If you live in SDA funded by the NDIS, a written service agreement with your provider is mandatory. More information about service agreements can be found on the NDIS website.
Changing Your Providers
You have the flexibility to change providers for any reason. Most service agreements include an exit clause, and you will need to agree on a termination date with your provider. If you’re unhappy with the support, consider discussing your concerns with the provider first. You can ask for assistance from someone you trust or an advocate. If you’re uncomfortable talking with the provider or dissatisfied with their response, contact the NDIS Quality and Safeguards Commission.
When to Inform the NDIS About Your Providers
You need to inform the NDIS about your providers for the following supports:
- Plan managers, support coordinators, or recovery coaches
- Behavior support
- Supported Independent Living (SIL) or Specialist Disability Accommodation (SDA)
These providers need to be recorded by the NDIS before they can be paid for your supports. If your funding is agency-managed, you can opt to inform the NDIS about any of your providers, allowing for quicker payment without needing to check with you for each claim. If you don’t inform the NDIS, they will still check with you before paying any claims to ensure accuracy.
For more information about working with providers, visit ndis.gov.au.