Pricing changes, new quality framework, and other challenges in managing what services you offer

Understanding and managing which supports your organisation or business can provide, and how to provide them, in the context of a changing NDIS is an important part of remaining economically viable.

The system is already inherently complex and sometimes difficult to negotiate, with some experiencing problems in getting paid due to delays within NDIA. That’s a huge barrier to managing cash flow.

However, factors including the recent pricing review, and NDIA’s new Quality & Safeguarding Framework, affect financial sustainability too. They influence which service categories make sense for a provider to deliver, depending on the skills and resources within your team.

For instance, the pricing review introduces new tiers for different therapies, introducing new ways of categorising need and requiring higher level skills for people delivering at the highest tiers.

This creates questions about how to determine which tier the client’s supports must be delivered at, and additional complexity within your organisation when it comes to matching skills with the supports being delivered, and claiming accurately.

Similarly, the quality framework due to start rollout in some states in July this year, puts national standards in place, which will change compliance obligations for some providers.

As a result some providers will find they now need to be certified and audited to deliver Registration Groups they are approved for. This could affect their business model significantly, and force a decision around sub-contracting services to others or changing/eliminating some Registration Groups.

In a general sense, properly managing the way you keep track of services is essential for your organisation’s longevity—simply because accuracy in delivering the right service—at the right price—by the right employee—is an essential part of submitting claims that get paid without hassle and remaining compliant.

What does properly managing services mean?

A source of confusion for some Comm.care clients in the past has been understanding the connection between the Registration Group they have been approved for, and the specific categories and line items they can actually deliver.

You may be approved for a Registration Group but not have suitably qualified staff to offer all the related line items.

You need to match services to a participant’s plan, but what a client needs is not described within plans by Registration Group—rather, by Support Category.

You need to ensure the person that delivers the service has the right qualifications or experience for that specific line item.

You also need to make sure that employees or other people involved in the delivery of care can find and attribute the right line item easily in the process of recording their work, so you’re not ripping off participants and can face an audit confidently.

How does Comm.care help you manage services?

Comm.care by Pnyx is designed to help you better support your clients, and improve the way you keep track of the support you provide.

An important step in setting up Comm.care is adding all of your services into the platform.

We recently upgraded the way services are added within our system to make it even more convenient and meaningful for NDIS providers.

The changes mean that a service can be refined based on both Support Category and Registration Group: this makes it faster to set-up a service with only the line items that you are able and committed to delivering.

For example, when adding an NDIS funded service, you start by inputting:

  • Support purpose
  • Outcome domain
  • Support category

As highlighted earlier, a Support Category might be applicable across multiple Registration Groups and therefore multiple line items.

If you input ‘Home Modifications’ as the Support Category, the client should be able to choose from line items that fall under at least four Registration Groups.

Comm.care allows you to filter by the ‘Area of Service’ and ‘Registration Group’ and then select the specific line items from within that group that you are certified/qualified/wanting to deliver.

Services can be easily updated as needed to add or remove line items, if your staffing or other organisational factors change. Any change to a service will flow through the Comm.care system, meaning that new line items can be chosen by delivery staff when they are recording their care delivery.

Why does this matter to my organisation?

Understanding the services you can deliver, and having effective systems to manage them, makes it quicker and easier to record and claim for what you’re owed.

Comm.care’s thorough and thoughtful approach to storing information about your Services is important for multiple reasons:

  • It enables specific Services to be linked to each client’s unique roadmap (outline of which services will be delivered in which time frames in order to help the client to reach specific goals)
  • It enables frontline providers and other team members to more easily and reliably create a ‘Progress Note’ that tracks care delivery and their billable hours. A person creating a ‘Progress Note’ can select only from relevant services/line items linked to that particular client’s roadmap.

You can see how this integrated approach to connecting services, participants’ plans and the way employees keep track of their activity and time makes for a more streamlined process. That means fewer opportunities for error, and a greater likelihood you can be paid for your work on time.

Want more information? Read our tutorial about adding services within the Comm.care platform.