SELF-MANAGED

To self-manage your plan means that you or a nominee (generally a parent or guardian) will control the budget and pay services directly. This plan gives you more choice and control, but you need to be organised and some people say it’s more work than other options.

This style of management means you have the freedom to use any services you want (even those not registered through the NDIS). You are responsible for finding the services that best meet your child’s needs and those that help you achieve the goals you identified within your plan.

Using this style of management you will be required to:

  • Pay for your own child’s services when you are invoiced or at the time of service provision.
  • Be prepared you may experience some out of pocket expenses until your claims are processed.
  • You can submit a claim up to one week before you access your services so that you have the money available to pay on the day.
  • Access the NDIS portal to decide which part/ category of your plan you will claim/ get reimbursement from.
  • You will then need to make the claim, keep records and show how you have spent funds at time of any audit.
  • It requires reporting to the NDIA how your self-managed funds are being used. The NDIS can audit participants at any time so keeping clear records is essential.

Why choose this option?

  • Great flexibility and good for people that like control.
  • You can use a range of service providers who are not NDIS registered.
  • Funds can be used flexibly.

We can assist you with managing your budget by developing a service plan outlining our goals and an estimate of costs for the duration of your plan.

PLAN MANAGED

The option of working with a plan management provider (plan manager) allows you to have the best of both worlds. You get the same choice of providers (those that are NDIS registered and those that aren’t) just as you do if you are self-managing your plan, but you don’t need to deal with the financial administration.

Working with a plan manager is a bit like having an accountant – you get to decide who your service providers are, but the plan manager receives and pays the invoices for you. Plan managers are NOT responsible for managing your budget – meaning you still need to keep track of how money is being spent and ensuring there is money available to the providers you want services from.  There are fees involved but the NDIS will cover them and there are no out of pocket expenses to you at the time of your child’s appointment.

Please note - When you go into your NDIA planning meeting, you will need to let them know that you want to choose this option because they will include the funding you need to cover the cost of a plan manager.

Why choose this option?

  • You get the some of the flexibility of self management without the stress of paying invoices.
  • Your plan manager will complete all the paperwork and keep the records required by the NDIS.

We can assist you with managing your budget by developing a service plan outlining our goals and an estimate of costs for the duration of your plan.

Remember, whatever option you choose, you’re not locked into it forever.

If you start down one path and realise it’s not working for you, talk to your LAC/ planner or call the NDIS on their hotline and talk to them about making the changes you need. 

MEDICARE REBATES – EPC/CDM

This program can be accessed through your GP – Enhance Primary Care or Chronic Disease Management plans. The eligibility criteria states that you must have a "chronic" condition (your condition is likely to impact you for over 6 months) and there needs to be 2 health professionals involved in providing services. Your GP must co-ordinate the Care Plan and send out the appropriate referrals to the involved health professionals (eg Coastwide Therapy Services). Under this program you can access up to 5 sessions per year for individual therapy rebated by Medicare. That’s 5 sessions to be shared between ALL allied health professionals eg OT, Speech pathology, physiotherapy – not 5 sessions for each type of therapy.  The Health Professional providing the service must be registered with Medicare. For Occupational Therapy the rebated amount is approximately $53 per session and as such there will be a gap (out of pocket expense) which our admin team can talk to you about at the time of referral.

FEE FOR SERVICE/ PRIVATE HEALTH FUNDING

You do not need a referral to attend Coastwide Therapy Services. Our Service Model Agreement, terms and conditions and policies are sent out to all those that access our service. Within our Service Model agreement you will find our fee schedule which outlines costs of sessions. This will also be explained to you by our admin team before your first appointment is made. We have EFTPOS facilities and receipts are issued on the day or emailed so you can easily claim against your private health insurance - if you have Occupational Therapy in your extras cover – please check with your private health fund.

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