With the introduction of funding periods, the need for monitoring budget data has never been greater. Simply, it allows you to claim with confidence, knowing that a participant hasn’t exhausted their funds within a specific funding period. Easy.

In this blog post, we unpack what funding periods entail and what techniques you can employ to some of the traps they are likely to present. Funding periods are still being rolled out, so it’s important you get appropriate processes in place now.

What are funding periods?

We explored funding in a previous blog post, but it’s worth revisiting. Funding periods are a new instrument created under Section 33 (2E) of the NDIS Amendment Act, resulting in funds being released in instalments across the life of a participant’s NDIS plan.

In simple terms, the change looks like this:

• Budgets: Variable Funding Periods (mostly quarterly), varying by support group
• Supports: Grouped into ‘Funding Components’, with each component having its own ‘Funding Component Amount’
• Unused Funds: Rolled over into next Funding Period unless there is Plan change

The change to funding periods means that, if a participant exhausts their funds during a period, you are unable to draw funds from the next period, leaving you unpaid for services delivered until the budget for the next funding period is ‘released’. Alternatively, if a participant doesn’t use their funds during a period, these funds roll over into the next.

For this reason, it’s vitally important you track, either via APIs or by asking your participants’ Plan Managers and Support Coordinators, budget data to determine whether a participant is at risk of exhausting their budget as this impacts your cashflow.

What is plan utilisation?

When we say plan utilisation, we simply mean the rate at which an NDIS participant is consuming the funds within their plan – avoiding both overspending and underspending.

As a provider, plan utilisation is about helping a participant get the most out of their NDIS Plan – and having certainty that you will be able to invoice for services delivered.

You can get such certainty using data obtained from Support Coordinators, Plan Managers or the NDIS Provider APIs.

How can you use NDIS APIs to calculate plan utilisation?

You can connect to the NDIS APIs either through the Digital Partnerships Office (DPO) – you must be a registered provider – or through an Aggregator. You will need to also get consent from participants, as the information you’ll be looking at is highly confidential.

Once you’re connected, you will want to explore two key data points, being total/remaining budget and plan start/end dates, before mapping these against one another. This will inform you if a participant is over utilising (they’ve got less budget than time remaining) or under utilising (they’ve got more budget than time remaining).

This data is valuable, but we caution you to remember that it’s unaware of context: for example, a participant might be over spending because they require extra support during a health issue and have lodged a change of circumstances.

What is best practice?

For plan utilisation to work, you need to get data in the right hands and train your staff on how to interpret the data in a way that understands context. Ideally, you want managers of frontline staff to be aware if budgets are being under or over utilised so that they can optimise service delivery to get back on track. That means communicating with the participants to explain the situation then adjusting rostering or schedules accordingly.

You also need to ensure that whoever is liaising with the Agency has access to this data so that if a plan needs to be varied, they’re armed with the facts to justify why that should happen before it’s too late.

Lastly, your billing team needs to be aware of the pace at which budgets are being consumed so that they can adjust their forecasts and act accordingly. If plans are being underutilised that means that there may be revenue shortfalls in the future, and similarly, if budgets are being overspent, you need to get ahead of that to avoid a situation where you’re accumulating debts without a plan to remediate them in the future.

Are there any ethical or privacy considerations?

You’re handling personal information here, you have a responsibility to balance privacy considerations when sharing this information. Similarly, when you’re building a system to calculate and distribute this information, you need to ensure that adequate security measures are in place so that it can’t be accessed by either internal or external actors who aren’t authorised to access it.

Lastly, when gaining consent, it’s important to explain to participants and their nominees exactly why you would like to have access to their data, and how you’ll be using it. At the end of the day, if it’s explained correctly, it should be clear that this data can be used to the benefit of participants, so it’s really a win-win situation.

Need help?

At quickclaim, we offer an end-to-end billing solution with API connectivity to support you appropriately and ethically utilise plans. Please reach out to our team to book a demo.