Delays to Short Term Respite payments
The NDIA have stepped up their focus to prevent fraudulant claims and ensure compliance with an updated claims review process.
We understand this may be causing some confusion for participants and service providers relying on timely payments. So, we’ve gathered all the key information here to help you understand the NDIA’s approach and how it may impact you.
While the NDIA aims to have valid claims paid within 2 to 3 business days, the reality is many claims are taking several business days to process. In some cases, claims are being held, reviewed, and sometimes denied after several weeks.
A growing number of STR claims and reimbursements are being rejected by the NDIA, especially if seen as 'holiday' expenses.
If you’re a customer with Plan Partners, our team will ensure we have all the necessary information and documentation before submitting your STR claim to the NDIA.
Our goal is to speed up the process for you and make sure your invoices have the best chance of being approved for payment.
More requests for additional info
There’s been an increase in the number of STR claims needing additional documentation to get approved. The types of information the NDIA may ask for includes:
- A signed Service Agreement between the service provider and the participant for the dates the STR occurred.
- If paid upfront, confirmation of the participant's accommodation, including a booking confirmation or paid receipt.
- Information about support worker(s) who attended the STR, including their name/business name and ABN, plus the roster of hours during the stay.
- A description of the supports provided by the support worker.
- An outline of the activities the participant engaged in during their STR.
- Any supporting evidence that makes it easier for the NDIA to understand your situation and why it’s for you to receive respite care, some of the questions we may ask to gather this information could include:
- Is Short Term Respite stated in your current plan?
- What is the purpose of STR and how does it support your goals?
- If you are using 1:1 supports, can you let us know the reason?
- If you don’t need a support worker, can you let us know the reason?
- Does the STR represent value for money? (e.g. luxury hotels vs reasonable accommodation)
- If you created your own STR rather than using a provider, can you share why?
Note: We recommend working with a STR provider to ensure your stay meets the NDIA guidelines.
Tips for managing STR spending and claims
Remember, STR isn’t for holidays
The NDIS operational guidelines clearly state that STR funding isn’t intended for holidays. This funding is meant for reasonable and necessary supports that are related to your disability (such as respite).
Seek advice
Before spending your funding on holidays, hotels, or vacation-like experiences, or if you need a support worker while travelling, consult with your NDIA Planner, Local Area Coordinator (LAC), or Support Coordinator first.
Get an invoice, don’t pay from your pocket
Whenever possible, avoid paying deposits or making out-of-pocket payments. A good STR provider will be happy to submit an invoice on your behalf. This way, any issues can be identified and resolved before payments are made.
Factor in longer processing times
It’s a good idea to anticipate delays and be super organised with your invoicing and fund management.
Report issues
If you encounter problems or concerns with delayed payments, report them to the NDIA. Your feedback can help pinpoint and fix system issues.
And finally…
If you’re a customer with Plan Partners, our team will work with you and your providers to minimise the impact of the increased processing times on Short Term Respite payments. If you’re unsure if you have funding for Short Term Accommodation, this should be written in your plan under core funding, alternatively give one of our friendly team members a call to check first before making plans.
And don’t forget, we’re also here to keep you educated and informed about important NDIS changes and updates as they unfold.