On Tuesday the 31st of October the National Disability Insurance Agency very quietly switched on their new IT system, PACE. Like us, you may ask what PACE stands for – the fact remains that we simply don’t know. From what we understand the NDIS have invested in this custom built, fit for purpose platform to provide better functionality and real time access to more granular data.
Testing of this new system has been underway in Tasmania since mid-November 2022 and it seems that our Tassie colleagues have had a range of experiences. At this point we issue a trigger warning for those providers who recall the horrors of the last IT Portal roll out in 2016…we pray for a better result this time.
In order to fast track our knowledge we attended the excellent information session delivered by our friends at Disability Services Consulting yesterday (recommended – purchase here).
Here are our key takeaways relevant to Allied Health – you may wish to follow up yourself for more details.
Registered Providers Punished. Again.
Registered providers once again are about to have salt poured into their auditing wounds as they end up the most adversely affected by the transition to PACE.
Provider Endorsement – My Provider
Participants who are Agency managing their plans will need to endorse their providers under the new My Provider designation in order for their providers claims to be paid within 2 – 3 days. Allied Health Business Owners who are supporting Participants who are Agency managing their plans will need to be listed under this section on their clients PACE My Provider list. We encourage you to think about how you can ensure that this done in a systematic way with your clients so that your claims can be processed efficiently.
Those who have not been endorsed will need to wait until the Participant has completed a cooling off period of 6 days during which they have an opportunity to decline the request for payment. If the payment is not declined, the payment will be processed in up to 10 days. This is a significant payment delay from the current and very reasonable couple of days. We caution you about potential cashflow, reporting and planning challenges and strongly encourage you to think this through sooner rather than later.
How many reasons can you think of for a participant to decline the request for payment your business has submitted?
If the Participant does in fact decline, we don’t yet know what the dispute resolution process is!
By the way, endorsement occurs when the Participant receives an SMS or email with a link to activate it. What could possibly go wrong?
Service Bookings Be-gone
With Service Bookings now all but a memory in the PACE system, one of the remaining practical advantages of being registered has been deleted. Now, registered providers require even more diligence in monitoring plan expenditure to ensure that they will be paid for their work. We have no idea how large providers will make this work without investing even more heavily in people, time and money to oversee the process of being paid. We have two words for all of you. PROFOUND VIGILANCE.
The potential for several failed payments for frequent attendees exists here before you are even aware of the problem if you are not monitoring budget balances and claiming frequently.
Unregistered Providers
Once again you are holding the Golden Ticket with few significant changes for you. Perhaps check-in with your Plan Managers as they begin to work with PACE as to how they might alert you that budgets are getting low. Many of them already do this. We have no visibility over how Participants who are Self-Managing are going to manage the new system and will be watching this space closely.
Continue as you were with daily invoicing and processing. More information below.
Same Same Different Day for Self and Plan Managed Participants
Fortunately for your Self-Managing participants not much will change, continue with encouraging pay on the day policies. As mentioned earlier, we will be watching to see how user-friendly the interface is and what support our Participants might appreciate obtaining from their providers to use it.
Plan Managers will automatically be endorsed in the PACE platform on the participants My Provider list. This means every invoice that they process will be automatically processed in the 2-3 day window (unless there is a good reason for them to decline the submitted payment). Good news here in that Plan Managers will have far better access to participants plan balances, closer to real-time.
Find those great Plan Managers and payment should continue pretty close to how it is now.
The Numbers May be Changing, or Not.
Keep an eye out for possible changes to claiming codes in the future as there have been changes to Support Categories (this is more likely to affect businesses claiming out of Core) and if these line item codes change you will have some clients using one code for PACE and some using the old code for PRODA. The Agency are suggesting that there will be no changes, but since the line items reflect the support categories in their sequence and there are new support categories, we imagine that new numbers may appear in the coming months.
The Long and Winding Roll Out
Unlike the last roll out (Hashtag Portal Crash 2016) this new PACE roll out is paced (pun intended) and at this stage has a much more slow and steady vibe.
This will begin with new Participants which we imagine will largely be the little ones coming through the Early Childhood stream. Also between November 2023 and February 2024 any Participants whose plan expires and they require changes to be made to their new plan will also transition to the new system. Plans that roll over in this period will remain on PRODA for now.
This means that for the next 18 months at least, businesses are likely to be straddling two systems and for many there will be a need to know which system their Participants are on because they will need to managed a little differently.
Hmm, alarm bells ringing for how you will need to support your customer service team to manage across two systems.
Breathe. This applies to Agency Managed participants only at this stage.
Single CLAIMING Cancelled.
Another feature to be cancelled in this process is single claiming. All claiming will need to go through the bulk upload system via Excel file. You can find a template on this page. This is relevant for businesses claiming via the portal for Agency Managing Participants only.
Alert! Providers of Behaviour Support and Home Living
At our first glance, the businesses who come out of this change at a significant disadvantage are those providing Behaviour Support and Home and Living Supports (new category). Put simply, you will not be paid AT ALL if you have not been endorsed as a My Provider by your Participants. Not even with the delayed process mentioned above.
Review your systems now and build in a supported model for Participants or their decision makers to get that endorsement completed efficiently during the intake process before a bottleneck develops at the point between referral and initiating supports, or worse, non payment for work that has been completed.
No Pressure.
Sigh.
Support Coordinators and Recovery Coaches
All Support Coordinators and Recovery Coaches will be required to interact with PACE whether they are registered or not. It is our understanding that they can receive and accept / decline referrals via PACE and will have budget and Plan balance oversight into the future. No doubt there will be more information on this, please see the NDIA website for details.
The Hallucination of the Upside
Hidden between what looks like more need for systems and resources to manage PACE-Y (we hope) new systems and resources is some hopefully good news. PACE will provide more purpose-built functionality, backed by the global consultants at Salesforce. Fingers crossed we can have confidence in the provision of a high spec, stable operating platform this time around. In addition, the NDIA will reportedly be able to gather and use more accurate and granular data with which to make more informed decisions to improve the overall scheme. Reportedly.
The Participants Voice and Perspective
There is no word from the NDIA about how Participants who will have barriers to accessing the PACE platform will be supported or alternative approaches for them. This concerns us greatly. We anticipate that it may well fall to providers, once again, to support and guide Participants in understanding the mechanics and their role in processing endorsement and service payments through PACE. You can do that with all of your spare resources (tongue firmly in cheek here).
Alert but not Alarmed.
“Now” is when you all need to get and stay informed and for businesses supporting Agency Managing Participants (otherwise known as Registered providers) it’s once again time to actively strategize the resources you need and direction to drive your business. Like really, really now.
There is detailed information available on the NDIS website.
Aaaand that’s a wrap.
A reminder that you don’t have to navigate business alone, we are here to co-pilot with you.
Here’s the link to book a Power Call for when you need it.
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