How are NDIS Price Guides managed in SupportAbility?
The National Disability Insurance Agency (NDIA) release periodic updates to the NDIS Price Guides.
SupportAbility relies on the official Support Catalogue CSV Price Guide data published by the NDIA. The NDIA is responsible for determining and publishing the pricing and rules for supports delivered under the NDIS and themselves state that 'a comprehensive listing of support ‘line items’ will be kept up to date on the NDIS website'. For these reasons, SupportAbility only uses Price Guide rules and Support Catalogue data officially published on the NDIS website.
Whenever the NDIA releases a new Price Guide (generally annually on July 1st), we upgrade SupportAbility to include this updated information.
Scope of amendments required
- the mechanics of the scheme itself and the rules for using these Supports,
- the rules that govern how and when Providers can transition to use the new prices in the Price Guide release,
- the compliance requirements around billing and reporting to Participants,
- the compliance requirements around service bookings and processing Bulk Payment Requests,
- the compliance requirements around group service Staff-to-Participant ratios,
- the Bulk Payment Request file format specification,
- the compliance requirements around gathering evidence and support logs for these supports, and
- many other things.
- the earliest the NDIA has ever received a new Price Guide and Catalogue was 1 week before it was due to take effect on July 1st. However, Price Guides are often amended several times, even after July 1st, to fix issues and errors. There is no pre-determined date that the Agency has communicated for new Price Guides to be released. Therefore the team at SupportAbility are all on standby in the weeks leading up to the Price Guide, waiting for it to be released and to then respond accordingly. This means that our Engineering team needs to design, architect, build test and deliver complex (and often financial impacted) solutions, as a priority, to a very tight deadline. Our Customer Success team are tasked with generating the associated learning material within this timeframe, whilst simultaneously handling all Provider communications and questions during this period.
- the Agency often release information and change the Price Guide rules without providing the level of detail that Providers require to transition and comply with the new Price Guide. Subsequently, this needs to be clarified and our channels to receive this clarification are via the NDS, email to the NDIA directly and feedback from our subscriber base.
When is the latest Price Guide updated in SupportAbility?
Generally, the NDIA publish new versions of the Price Guide with two key documents:
- NDIS Price Guide: The NDIS Price Guide is published on the NDIA website in PDF/DOCX format and explains the rules around how supports in the Support Catalogue are to be delivered and claimed.
- NDIS Support Catalogue: The NDIS Support Catalogue is a Comma Separated Values (CSV) file containing a list of every support that is valid for the Price Guide release and contains pricing and other information for each support. This is the file we import into SupportAbility.
SupportAbility requires the NDIA to publish the Support Catalogue CSV as well as the NDIS Price Guide before we can begin work on including this in SupportAbility.
As a general rule, we update SupportAbility to include the new Support Catalogue within 2-3 weeks of the NDIA releasing the Support Catalogue CSV version associated with a new Price Guide. This may differ in cases where:
- There are issues with the NDIA price guide released, and several amendments are made before the 'final' version of the price guide is released, and
- The NDIA has changed the structure of the Support Catalogue or made significant changes to the rules of the Scheme in the Price Guide in which case, additional programmatic changes to the product need to be made.
IMPORTANT: On most of the previous Price Guide releases, the NDIA has released several versions of the Price Guides to amend serious issues in the data. If the Agency release amendment versions of the Price Guides, this can postpone the integration date for SupportAbility.
Is this being reviewed regularly so that SupportAbility is using the latest Price Guide?
Yes. Our Engineering team reviews the published Support Catalogue CSV data on a regular basis to check if a new version has been published, as historically the NDIA has not communicated when a revised version has been published.
What happens when a new Price Guide is added to SupportAbility?
Once a new NDIS Price Guide is added, Price Guide Transitions are created for all NDIS Direct Client Funding records that span a period of two or more Price Guides.
Where a Price Guide Transition is set to 'As soon as available', SupportAbility will update all Activities that fall on or after July 1st, that have not been Signed Off, to ensure that Client's NDIS Support Allocations reference the latest Price Guide. For more information on this, please review the Price Guide Transition article linked below.
N.B. Where a Client Support Log exists, this locks the Client's NDIS Support Allocations, therefore the only exception to the above rule is if a Client Support Log had been completed, then these allocations will not be updated.
Regardless of the transition settings, specific rules regarding which Claim Types can be used, for example, will always follow the rules of the NDIS Price Guide valid on the date of the Activity.
What if Supports are removed from the latest Price Guide?
In the case where a Support Item included in the Client's NDIS Direct Client Funding record is removed from the latest Price Guide, if their Price Guide Transition is set to 'As soon as available', the latest NDIS Price Guide applies and then the removed Support Item will not be available to select in the NDIS Support Allocations window of the Activity.
If your organisation has an active Service Booking and can claim for this Support, you may wish to choose to 'Never' use the latest Price Guide, or set a specific date following the Invoicing and/or NDIS Bulk Payment Request for this item being processed.
However, the drawback to this is that your organisation will not be using the latest Price Guide for this participant, and this may impact being able to charge at the updated price. If your organisation wishes to use the latest Price Guide 'As soon as available', you may choose to claim for this Support manually in the myplace provider portal.