The Most Common Pricing Mistakes (And Fixes)

Will, EnableUs Community

Alright, welcome back to Inside NDIS, everyone. Will here, and as always, I'm joined by Winter. Today, we're diving into the most common pricing and claiming mistakes that trip up NDIS providers. And honestly, some of these are so easy to make, even if you think you've got it all sorted.

Winter, EnableUs Community

Hey folks! Yeah, this is one of those episodes where you might wanna grab a notepad, because even the most experienced providers can get caught out. We're talking about the top ten mistakes—like, using the wrong line item code, charging above the price cap, or just, you know, not keeping up with the latest NDIS Support Catalogue. It's a lot to keep track of.

Will, EnableUs Community

Yeah, and I mean, the Support Catalogue changes every year, right? I remember, actually, I nearly submitted a claim with an old code once. I was in a rush, just grabbed the code from memory, and then—luckily—someone on the team double-checked it. Turns out, the code had changed in the July update. If we hadn't caught it, that would've been a rejected claim, and probably a headache for the participant too.

Winter, EnableUs Community

Oh, that's such a close call! And it's not just codes, right? Charging above the price cap is another big one. If you're a registered provider, you can't just set your own rates. The NDIS Pricing Arrangements are, like, your bible. And if you're unregistered, you still need to be super clear with participants about what they're paying for. Transparency is everything.

Will, EnableUs Community

Absolutely. And, you know, using invoicing software that automatically applies the price caps can save you from those accidental overcharges. But you gotta make sure it's updated every year, or else it's just as risky as doing it manually.

Winter, EnableUs Community

And then there's the classic—claiming from the wrong budget category. Like, billing a Core support from Capacity Building funds, or the other way around. It's easy to mix up, especially if you're new to NDIS or if the plan's a bit complicated. But it can really mess up a participant's budget and your own records.

Will, EnableUs Community

Yeah, and honestly, sometimes the difference between Core and Capacity Building isn't super obvious. I always say, if you're not sure, just ask the participant or their Support Coordinator. Better to double-check than have to fix it later.

Winter, EnableUs Community

And don't forget about service agreements! Providing supports without a signed agreement is a big no-no. You need that documented consent, with clear pricing and line items. Otherwise, you could be left out of pocket—or worse, lose trust with the participant.

Will, EnableUs Community

Yeah, and we'll get into that a bit more in a sec. But just to round out this chapter—other mistakes we see all the time: claiming for non-claimable activities, overclaiming travel, not updating prices after July, not having enough documentation, rounding up time, and claiming outside your registration group. It's a long list, but honestly, most of these can be avoided with a few simple checks.

Winter, EnableUs Community

So, let's talk about budgets and agreements. Matching services to the right budget category is, like, the foundation of good NDIS management. If you mix up Core and Capacity Building, you can end up with a participant running out of funds in one area and having too much in another. It's not just a paperwork thing—it really affects people's lives.

Will, EnableUs Community

Yeah, and I think a lot of providers underestimate how important it is to educate their team on this. Like, it's not just the admin staff who need to know—everyone delivering services should understand which budget they're drawing from. Otherwise, you get these weird situations where, you know, a participant can't access something they need because the funds are in the wrong spot.

Winter, EnableUs Community

Exactly. And on the agreements side, I actually had a provider I worked with who lost funding for a whole term because they didn't get the service agreement signed. They'd started supports, everything was going well, but when it came time to claim, there was no signed agreement. The participant's plan manager just said, "Sorry, can't pay it." It was a hard lesson, and now I'm, like, obsessed with making sure every agreement is signed, clear, and updated whenever prices change.

Will, EnableUs Community

Yeah, that's rough. And it's not just about getting the signature, either. The agreement needs to spell out the pricing, the line items, how often the service is delivered—all of it. Otherwise, you end up with confusion, or worse, disputes down the line.

Winter, EnableUs Community

And honestly, using a templated onboarding checklist can help so much. Just tick off each step—get the agreement, check the codes, confirm the budget category. It sounds basic, but when you're busy, it's easy to skip a step and then regret it later.

Will, EnableUs Community

Yeah, and I mean, the NDIS changes things every year, so you really do need to review and update agreements and systems every July. Set a reminder, train your team, and let participants know about any changes. It's just good practice.

Winter, EnableUs Community

Alright, so let's get into how you actually build trust—because that's what it all comes down to, right? Accurate claims, solid documentation, and following the rules on things like travel and service times. If you get those right, audits aren't nearly as scary.

Will, EnableUs Community

Yeah, and travel claims are a big one. You can't just estimate the time or distance—you need to log every trip, with the exact times, kilometres, and which participant it was for. And only claim for travel if it's allowed under the relevant line item. Otherwise, you're just asking for trouble if you get audited.

Winter, EnableUs Community

And documentation—oh my gosh, it's so important. Progress notes, session logs, records of cancellations, participant authorisations... If you don't have the evidence, you can't justify the claim. I always say, if you had to show your records in an audit tomorrow, would you feel confident? If not, it's time to tighten things up.

Will, EnableUs Community

Yeah, and there are tools out there that make this easier. Time-tracking apps, recordkeeping systems, even just a good old cheat sheet of your most-used codes. Actually, I heard about a provider who made a simple cheat sheet for their admin team—just the correct item codes, price caps, and travel rules. It sounds basic, but it totally overhauled their claiming system. Their next audit went way smoother, and they saved heaps of time on corrections.

Winter, EnableUs Community

I love that. Sometimes it's not about fancy software, it's just about having the right info at your fingertips. And making sure everyone on the team knows the process. That's how you build trust—with participants, with plan managers, and with the NDIS itself.

Will, EnableUs Community

Yeah, and look, mistakes happen. But if you've got good systems, regular checks, and you keep up with the annual changes, you can avoid most of the big ones. And you'll build a reputation for being reliable, which is honestly priceless.

Winter, EnableUs Community

Totally agree. Alright, that's a wrap for today. If you found this helpful, make sure to subscribe, because we've got more episodes coming up on plan management, strategic budgeting, and all the nitty-gritty of NDIS pricing.

Will, EnableUs Community

Thanks for tuning in, everyone. Winter, always a pleasure chatting with you. See you next time!

Winter, EnableUs Community

Thanks Will! Bye everyone, and remember—double-check those codes!