Billing Plan-Managed NDIS Participants: What Is Different and What Goes Wrong

How plan-managed billing differs from agency managed

With agency managed participants, you submit a bulk payment request directly to the NDIA myplace portal and NDIA pays you. The process is standardised, the payment timeline is predictable (usually two to five business days), and NDIA enforces rate caps at their end.

With plan-managed participants, a registered plan manager holds the participant's NDIS funds on their behalf. You do not submit to NDIA at all. You invoice the plan manager, and the plan manager pays you from the participant's funds. The plan manager then handles their own reconciliation with NDIA.

This introduces a private entity into your payment chain. Every plan manager is different. They have different invoice requirements, different turnaround times, different processes for querying invoices, and different responsiveness when something goes wrong. Managing accounts receivable for plan-managed participants requires more active tracking than agency managed billing.

Common plan manager invoice requirements

Most plan managers require the following on every invoice:

Some plan managers have additional requirements: their own purchase order or reference number, a specific invoice format or template, or a requirement that invoices be submitted through their own portal rather than by email. When you take on a new plan-managed participant, ask the plan manager for their invoice requirements before you send the first invoice.

Payment terms and tracking outstanding invoices

Agency managed payments are typically received within five business days of submitting to myplace. Plan manager payment terms vary widely. Common payment terms are 14 days, 30 days, or 45 days from invoice date. Some plan managers pay faster; some are slower.

Because payment comes from a private entity rather than NDIA, you need to track unpaid invoices actively. An invoice that has been sent but not paid within terms requires a follow-up with the plan manager, not with NDIA.

In Teiro, plan-managed invoice status moves through: Draft, Sent, Overdue, and Paid. Invoices past their due date are surfaced in the billing dashboard so the billing officer can follow up. Mark invoices Paid when payment is received and record the payment date.

If a plan manager consistently pays late or disputes invoices, this is a conversation to have with the participant and potentially with NDIA. The participant chose their plan manager, and persistent payment issues affect your ability to sustain service delivery.

What happens when a participant changes plan managers

Participants can change plan managers during their plan year. This is not uncommon. When it happens:

In practice, the changeover date is sometimes not communicated to the provider promptly. You may discover the change when an invoice to the old plan manager is returned or queried. When you learn of a changeover:

1. 1.Update the plan manager contact in the participant's SA in Teiro to the new plan manager
2. 2.Determine the changeover date precisely -- the new plan manager or the participant can confirm this
3. 3.Audit your recent billing runs to check whether any post-changeover-date services were invoiced to the old plan manager
4. 4.If invoices went to the wrong plan manager, issue a credit note to the old plan manager and a new invoice to the new plan manager for the same services

Do not send the same invoice to both plan managers hoping one will pay. This creates a genuine duplicate payment risk.

Mixed-management participants

A participant can have different supports funded through different management types within the same plan. Core supports might be agency managed, while capacity building is plan-managed. This is called mixed management.

For a mixed-management participant, your billing system needs to separate claim lines by management type at billing run time:

If your billing system treats all lines for a participant the same way regardless of support category, you will route claims to the wrong entity. NDIA will reject lines that should go to a plan manager, and the plan manager will receive lines that should have gone to NDIA.

In Teiro, management type is configured at the service agreement line level, not at the participant level. This allows a single participant to have some supports agency managed and others plan-managed, with the billing run handling the separation automatically.

Common errors in plan-managed billing

Wrong invoice recipient. A claim goes to NDIA via the BPR rather than to the plan manager, or vice versa. This happens when management type is set at the participant level rather than the SA line level, or when a bulk upload at intake sets all participants to the same default type.

Missing required fields. The plan manager queries the invoice because it is missing the NDIS participant number, the support item code, or the plan manager's own reference number. The plan manager may delay payment until the corrected invoice is received.

Invoice sent to old plan manager after changeover. The participant changed plan managers and nobody updated the record. Invoices flow to the old plan manager who cannot pay them from a plan they no longer manage.

Chasing payment from the participant instead of the plan manager. Self-managed and plan-managed billing are often confused. A plan-managed participant's funds are held by their plan manager, not by the participant. With a self-managed participant, the participant claims the funds from NDIA themselves and pays you directly -- but with a plan-managed participant, funds go through the plan manager. Asking a plan-managed participant to pay directly creates confusion and may damage the relationship.

No follow-up process for overdue invoices. Accounts receivable from plan managers can age significantly if there is no systematic follow-up. Unlike NDIA payments, which are predictable, plan manager payments require active management.

Book a demo to see how Teiro handles plan-managed billing, or sign up free for organisations with 5 or fewer active users.