What is a manual payment request?
If a participant’s entire plan funding is exhausted in a category, invoices cannot be paid. This does not refer to funding being exhausted within a funding period. Outstanding invoices must be sent to the NDIS provider payments team to request the NDIS add funding and make the payment.
NDIS legislation means funding can only be added if the CEO is satisfied that:
(5) (a) the relevant event would occur because the participant has experienced fraud or financial exploitation; or
(5) (b) making the payment is necessary to prevent or lessen an imminent threat to an individual’s life, health or safety; or
(5) (c) the participant has been unable to request a variation or reassessment of the participant’s plan because of one or more of the participant’s impairments or a lack of decision‑making support; or
(5) (d) the participant has requested a variation of the participant’s plan covered by subparagraph 47A(1)(d)(i) or (1AB)(j)(i) (crisis or emergency funding as a result of a significant change to the participant’s support needs), and neither of the following apply:
(i) the CEO has made a decision on the request to vary the plan and the variation has taken effect;
(ii) the CEO has made a decision on the request not to vary the plan (including because of the operation of subsection 47A(5)); or
(5) (e) a circumstance prescribed by the National Disability Insurance Scheme rules for the purposes of this paragraph exists.
NDIS Requirements
When a plan manager submits an invoice for manual payment, NDIS invoicing rules must be followed, otherwise it will be rejected.
Your invoice must show:
- The participant’s name and NDIS number.
- Each service / support on a separate line and the type (eg. NF2F) clearly marked for each line. If you are claiming for report writing, non-face to face charges or travel charges, these all need to be on a separate line.
- The quantity (hours or units) and the hourly / unit price shown for each line. These need to be within the NDIS pricing arrangements maximum limits.
- The total for each line of service and the invoice grand total.
- The dates of services / supports provided.
- Any partial payments made on the invoice need to be shown and deducted from the total.
- A support item code for each service provided.
- Invoices spanning multiple plans may be rejected, unless each line clearly shows the date of service. In practice, it is best to submit a separate invoice for each plan period.
Once your invoice contains the above details, you can submit it to us for claiming.
Things to Note
- Invoices cannot be submitted during an active plan – we must wait until the plan ends and a new one has been issued.
- All invoices for outstanding supports should be submitted together in the same claim.
- Supporting documentation should be submitted with the invoices. If a provider is unable to supply this documentation, then the participant / nominee or support coordinator may be able to provide it.
- There is no guarantee the NDIS will approve extra funding once the budget has been exceeded. In this case, the participant bears the responsibility for payment of outstanding invoices.
- Response times from the NDIS can vary and may take several months.
We will keep you updated on the status and notify you as soon as we receive a response or can process the payment.