NDIS Plan Management: How to Review Your Claims and Invoices

When you use plan management, it is still important to review NDIS claims and invoices so you understand what providers are charging you for and how you are using your NDIS funding.

Reviewing your invoices, claims and spending statements helps you keep track of your budget, identify possible errors and make informed decisions about your supports.

What’s the difference between an invoice and a claim?

An invoice is a document from a provider showing the supports or services they’re charging for. It usually lists the type of support, the delivery date, the quantity or hours, and the amount charged

An NDIS claim is a request for payment from your NDIS funding

When you use plan management, your provider generally sends an invoice to your plan manager. Your plan manager checks that the claim meets NDIS requirements, obtains your authorisation, submits the claim to the NDIA, and pays the provider after receiving the funds.

Your plan manager also keeps records of your spending and provides regular financial statements.

Understanding the difference can make it easier to see how a service you’ve received becomes a payment from your plan.

Step 1: Check what your provider is charging you for

When you receive an invoice, start by checking whether the services listed match the support you’ve received.

Look for these details:

• Provider details: Is the business or provider familiar to you? Does the invoice include the provider’s business name, ABN, and relevant NDIS support item number?
• Support dates: Do the dates match when you received the service?
• Description: Does the invoice explain what support was provided?
• Hours or quantity: Do the amounts match the support you received?
• Charges: Do the unit price and total amount appear correct?
• Duplicate charges: Has the provider already invoiced you for the same support?

For example, if your invoice shows four hours of support but you only received three, ask your provider or plan manager to check the difference.

You can also compare the invoice with your service agreement, appointment records or other information you have.

Some invoices may include charges for cancellations, provider travel or other items. These charges must meet the applicable NDIS pricing and claiming rules, as well as any relevant terms in your service agreement. Not every additional charge meets the requirements for payment from your NDIS funding.

If something is unclear, ask your provider or plan manager to explain it before your plan manager submits the claim.

Step 2: Understand how you authorise claims

Your plan manager needs to make sure claims are consistent with your NDIS plan, available funding and NDIS requirements.

You also have a role in authorising claims.

Your plan manager must obtain your authorisation when managing claims and paying providers.

When you first start working with a plan manager, agree on how you will authorise claims.

Different arrangements are possible. For example, you may prefer to check and approve invoices individually, or you may give standing authorisation for regular supports you already know about, such as ongoing weekly support. You can agree on the arrangement that suits you and change it later.

The important thing is that your plan manager has your authorisation and that you understand how the process works and know how to raise a concern.

You can ask your plan manager:

• Will I receive copies of my invoices?
• How will I know which claims my plan manager has submitted?
• What happens if I disagree with an invoice?
• How do I change my invoice authorisation arrangements?

Having a clear authorisation process helps you stay informed about payments made from your funding.

Step 3: Review your monthly spending statement

Your plan manager must provide a monthly financial statement.

How will I know which claims my plan manager has submitted?

When reviewing it, check:

• How much funding you’ve spent.
• How much funding remains.
• hich support budgets you’re using.
• Whether spending is consistent with your expected support needs.
• Whether your remaining funding is likely to cover your planned supports.

For example, if you receive support every week, you can compare your recent spending with the amount you expect to use over the coming weeks or months.

Keep in mind that some NDIS plans have funding periods that determine when funding becomes available. You may not be able to access your entire plan budget at once. Unused funding generally carries over to the next funding period within the same plan, but it does not carry over to a new plan.

If spending seems higher or lower than expected, ask your plan manager to explain the difference.

Regular reviews can help you identify concerns before they become larger budget problems.

Step 4: Review NDIS claims and invoices in your portal

You can also check information about your funding through the NDIS participant portals or the my NDIS app.

Depending on which NDIS system your plan uses, you may have access to the my NDIS participant portal or the myplace participant portal.

These tools can help you view your plan, check available funding and review claim information.

You don’t need to rely only on your monthly statement. You can ask your plan manager for an updated spending report or an explanation of a particular claim.

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Remember that your plan manager may not manage every support in your plan. Check which parts of your plan your plan manager handles when comparing your records.

If you’re unsure how to access your information, your plan manager or an NDIS contact can help you understand where to look.

Step 5: Check whether charges are within NDIS price limits

The NDIS pricing schedules set maximum prices for many plan-managed and NDIA-managed supports. The current NDIS pricing determination sets these limits.

The NDIS publishes these limits in its pricing schedules. The limits may vary depending on the support, location and applicable claiming conditions.

However, a maximum price is not automatically the price that every provider must charge.

You should check the amount against your service agreement and the pricing rules that apply to the support.

If a charge looks different from what you expected, ask your provider or plan manager to explain it.

You can also refer to the NDIS pricing arrangements for more information.

Prices and claiming rules can change, so check the guidance that applies to the date the provider delivered the support.

Step 6: Know what to do if an invoice or claim looks wrong

Mistakes can happen. You might notice an incorrect date, an unexpected charge, a service you don’t recognise, or an invoice the provider appears to have submitted twice.

If something doesn’t look right, start by contacting your plan manager.

Explain which invoice or claim you’re concerned about and ask them to review it.

Your plan manager can help clarify the invoice or payment issue and, where appropriate, contact the provider. However, they are not necessarily the decision-maker if you and a provider disagree about a charge. The provider may also need to explain the charge or correct the invoice.

If your plan manager hasn’t processed the invoice yet, ask about the authorisation process and what they can do while checking the issue.

If the NDIA has already paid the claim, ask your plan manager what steps you need to take to correct the error.

Keep copies of relevant invoices, emails and any corrections.

If your concern involves a provider’s conduct, unfair charging or suspected misuse of NDIS funds, you can contact the NDIS Quality and Safeguards Commission. You can also report suspected fraud or misuse of NDIS funding directly to the NDIA through its fraud reporting service.

The Commission handles concerns about NDIS providers and workers. For issues about NDIA funding decisions or NDIS payment systems, contact the NDIA instead.

Step 7: Review NDIS claims and invoices regularly

You don’t need to become an expert in NDIS invoicing to stay informed about your funding.

A simple routine can make reviewing your spending more manageable.

For example, you could:

• Check unfamiliar invoices when you receive them.
• Read your monthly spending statement.
• Compare recent claims with the supports you’ve received.
• Ask about charges or changes you don’t understand.
• Discuss future spending with your plan manager if your budget appears to be running low.

You can also ask a trusted family member, nominee or support coordinator to help you understand your statements, where appropriate and with the necessary authority or consent.

Your plan manager can help explain your spending and answer questions about the financial information they manage.

Related article: How to Choose an NDIS Plan Manager

Staying informed about your NDIS funding

Regularly review NDIS claims and invoices to understand how you are using your NDIS funding. By checking charges, monitoring your spending and asking questions when something is unclear, you can make more informed decisions about your supports.

Your plan manager should make this easier by providing clear financial information, answering your questions and helping you raise and clarify payment concerns.

If you’re looking for a plan manager who keeps you informed and makes managing your NDIS funding easier to understand, get in touch with Ormeau Plan Managers. We’d be happy to talk through how we can help.