The NDIS (National Disability Insurance Scheme) is a funding program for Australians under the age of 65 who are living with a significant and permanent disability.
The NDIS was developed to help people with a disability access additional funds in order to live a better life, stay at home longer, and be active in the community.
As a federal scheme, the NDIS is a partnership between states/territories and the federal government.
Previously, funds were allocated among different state schemes. Under the NDIS, such funding has been consolidated, which has made it standardised for Australians to access and retain certain benefits.
For example, an individual moving from Victoria to New South Wales can quickly access healthcare and not need to separately apply for another state scheme.
The NDIA (National Disability Insurance Agency) is the governing agency that manages the NDIS.
The schemes set pricing limits on the services we can bill (e.g assessments, device trials, etc). For our time, there is a standard rate that we bill based only on the time we use.
For equipment, each individual item is quoted based on the work required to make it and the cost of the device. The NDIS will typically approve funding for anything that is justifiable in the care and treatment of patients, including devices and the time our patients spend with our Orthotists.
After an appointment, we will provide a receipt, which a patient can use to claim those funds back.
The process to claim funds is different depending on how a person is managing their NDIS plan, typically this is:
- Self-managed – the individual will submit this on a NDIS portal
- Plan managed – we send the invoice to their NDIS support coordinator who will submit this on behalf of their participant
- Agency managed – Orthotics Plus submit this through a NDIA portal on behalf of the participant
Our services can fall under multiple NDIS-specific funding categories.
There are currently three Assistive Technology categories:
- Low cost assistive technology: under $1,500 per item
- Mid cost assistive technology: between $1,500 and $5,000 per item
- High cost assistive technology: over $5,000 per item.
Ancillary items such as prescribed footwear, off-the-shelf footwear, spare straps for an AFO, and electrodes for an FES device are billed under the consumables category.
Finally, there’s a separate funding category for capacity building, which is the time our Orthotists spend during assessments and treatment (consultations, report writing, liaising with other health professionals, etc).
No, we do not have access to these records by default.
We rely on the patient, guardian or support coordinator to provide us with the appropriate documentation and consent.
Prior to the release of any information, however, we will always consult the patient first and gain their approval.
We may request to share patient information with other treating clinicians. For example, if we’re working closely with a Physiotherapist, we may discuss our plan with the Physio to ensure that we’re all heading in the right direction given the patient’s condition.
Additional information may also be shared with the support coordinator to ensure we can access funding.
We would normally receive the referral from that health professional first.
These are submitted on our online referral form, however, we can also provide PDF fillable forms if necessary.
The respective referrer may also phone us to discuss the situation. Our lovely administration team would then schedule an appointment. This is often in person at our multiple Melbourne clinics or in rarer cases, through telehealth.
We recommend visiting the NDIS website to review eligibility criteria.
We recommend being aware of Local Area Coordinators (LACs) whose role is to help people understand, access and implement NDIS plans.