Funding Options

NDIS

Coastwide Therapy Services is a registered provider under the NDIS and in 2018 completed Third Party Verification with 100% compliance. We provide Occupational Therapy to children, adolescents and adults who have an NDIS plan.

What is the NDIS?

The National Disability Insurance Scheme (NDIS) is a scheme designed to help improve disability services and provide greater control and decision making to Australians with disabilities. An eligible participant meets with a local area coordinator (LAC) who work together with you to identify what current and future supports you believe are most important for your child (your goals).

You will then receive a plan with an allocated amount of funding allowing you to purchase services, aids and/ or equipment from a variety of service providers that YOU choose. From a therapy perspective this may include Occupational Therapists, Speech pathologists, Physiotherapists, Psychologists, Educationalists and Allied Health Assistants.

Please note: You DO NOT have to have all your child’s therapy provided at the same service, it is your choice and you can choose to leave a provider at any time just by giving them notice (verbal or written). Never feel locked in, you have control over the services you decide fit best with your family.

The NDIS can be a confusing and sometimes challenging path to walk when you are new to the system. Here is some general information to get your head around how you might choose to manage your child’s NDIS plan. You should always discuss these options with those people who are helping you to prepare and plan like your Local Area Coordinator (LAC) or NDIS planner.

Most people choose 1 of 3 options when managing their child’s plan (budget). Or some people use a combination of these an this can be discussed at your planning meeting.

Agency-managed
Self-managed
Plan management provider

AGENCY-MANAGED

Often people who are new to the NDIS and may be receiving their first plan will choose this option. Essentially it means that the NDIS will manage the funding in your plan. People commonly use this option for their first 12 months while they become used to the new system, once they become more confident they may choose another option for their next plan such as self or plan managed.

Please be aware - Under this type of funds management you can only use service providers registered with the NDIA (like Coastwide Therapy Services). You will need to check with your other providers if they are registered.

Why choose this option?

Easy and stress free
You do not have to pay providers. Service providers invoice the NDIS directly.
This option allows you the chance to learn the system before deciding to plan or self-manage.

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.

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.