Billing & Payments Policy

This page outlines Benefact’s Billing & Payments Policy. Existing clients should check their current Service Agreement and Schedule of Supports & Monetary Costings documents for further details.

Schedule of Supports

Benefact Occupational Therapy agrees to provide the Participant with assessment, report, and necessary training to facilitate achieving of goals as per their current NDIS plan.

All prices are GST inclusive (if applicable) and include the cost of providing supports inclusive of:

• Direct and indirect (Face-to-Face and/or Non-Face-to-Face) Occupational Therapy service provision (e.g., clinical assessment or intervention provided as a face to face or telehealth service, attendance at clinically relevant case meetings, equipment trials, care management, treatment review and planning, liaison with the Participant and/or third parties as clinically indicated, research, report writing, etc);

• Provider travel (charged at OT hourly rate + p/km); and

• Short notice cancellations (less than 48 hours) or no show[1]

Pricing for services are directly aligned withing those outlined within the NDIS Price Guide in force on the day of service provision. Additional expenses (i.e. things that are not included as part of a Participant’s NDIS supports) are the responsibility of the Participant / Representative and are not included in the cost of the supports. Further information regarding NDIS service pricing may be found on the NDIS website.

It is the responsibility of the Participant and/or relevant party to ensure that sufficient funds are available within the Participant's NDIS plan to cover the costs of service provision.

Pricing for services are directly aligned as per those listed within the NDIS Price Guide in force on the day of service provision. This means that any changes (inclusive of both increases and decreases) in NDIA published price limits on the day of service will be factored into amounts invoiced by Benefact Occupational Therapy.

Any additional expenses (i.e., things that are not included as part of a Participant’s NDIS supports) are the responsibility of the Participant. Further information regarding NDIS service pricing and updates may be found on the NDIS website.

Payments

Remittance advice should be sent to billing@benefact.com.au. Self managed participants are strongly encouraged to use Benefact’s Remittance Declaration Form to maintain compliance with NDIS and Benefact payment policies.

It is expected that outstanding invoices are paid in full within 7 days of notification. Benefact Occupational Therapy reserves the right to withhold or terminate services in the event of non-payment. Participants with accounts outstanding by more than 30 business days will be deemed personally liable for service provision costs paid in full; this will involve the Participant's outstanding account to be referred to an external debt collection agency for settlement.

Outstanding balances must be paid in the event that the Participant is marked as deceased, or moves onto a new provider[3]. This includes, but is not limited to: semi-completed report, equipment supply and prescription, ongoing liaison regarding ongoing clinical matters (e.g. arrangement for AT trials or housing modifications), reports (reports in works will be billed as per progress incl. care management and liaison related to same), discharge summaries, clinical handover, and other tasks related to OT scope of practice.

Occupational Therapy Service Provision

Benefact Occupational Therapy provides services via the Capacity Building - Improved Daily Living component of your plan. Line items are inclusive of:

• 15_617_0128_1_3: Assessment Recommendation Therapy or Training Supports - Occupational Therapist

• 15_799_0128_1_3: Provider travel - non-labour costs

• 15_053_0128_1_3: Therapy Assistant (Level 2 - Occupational Therapy)

Benefact Occupational Therapy may claim for flexible supports via your Core Supports funding if it is deemed that there is insufficient funding available to provide services as required via the line items above[4]. These line items include:

• 01_661_0128_1_3: Assessment Recommendation Therapy or Training Supports - Occupational Therapist

• 01_799_0128_1_1: Provider travel - non-labour costs

Low Cost/Low-Risk Assistive Technology

On occasion, it may be necessary for Benefact Occupational Therapy to purchase Assistive Technology (AT) deemed Low Cost/Low Risk on your behalf. In these instances, Benefact Occupational Therapy must be satisfied that items to be provided meet the NDIA’s Reasonable and Necessary guidelines, be therapeutically appropriate, assist in helping you achieve your goals, and be appropriately priced.

If required, Benefact Occupational Therapy will invoice for Assistive Technology via the line items listed below, as per flexible support funding included within your Core Supports budget. AT purchases are not included within your quote for OT services unless otherwise specified. All participants are strongly advised to seek OT advice and written clinical justification prior to purchasing low cost AT via their NDIS plan.

• 15_222400911_0124_1_3: Low Cost AT - Support Capacity Building

• 03_060000911_0135_1_1: Low Cost AT - Prosthetics Andb Orthotics

• 03_090000911_0103_1_1: Low Cost AT - Personal Care and Safety

• 03_120000911_0105_1_1: Low Cost AT - Personal Mobility

• 03_220300911_0113_1_1: Low Cost AT - Vision Related AT

• 03_222100911_0124_1_1: Low Cost AT - Communication or Cognitive Support

Please note that Benefact Occupational Therapy is unable to be held responsible for product warranty and/or quality of any assistive technology prescribed and/or purchased on your behalf.

Furthermore, it is to be noted that Benefact Occupational Therapy is that of a separate, and strictly independent entity from the supplier and manufacturer/s of all items prescribed – both in the case of items purchased on your behalf, and those provided directly via other suppliers via clinical prescription/referral.