5min read

How to Avoid NDIS Fraud as a Participant or Provider

Unfortunately, there are some providers of NDIS service who don’t have the best interest of the participant as their first. The NDIS was designed to help people with disabilities access the necessary services and support they require to lead an independent and fulfilling life. 

NDIS fund refers to the funding that eligible participants receive under the NDIS. This funding is tailored to meet the individual needs and goals of each participant. The funds are used to purchase a wide range of services and supports that are deemed reasonable and necessary for the participant’s specific disability-related requirements.

Sadly, fraud is a real possibility that all participants and their support team need to be vigilant against.

There are certain individuals and even organisations that take advantage of the benefits provided by the NDIS. In most cases, these individuals commit NDIS fraud by intentionally providing false information, misusing funds, or engaging in other deceptive practices to receive NDIS funding or services they are not entitled to.

How to Identify NDIS Fraud

Fraudsters usually utilise a variety of strategies to take advantage of the NDIS program. These tactics are commonly tailored to take advantage of either NDIS providers or participants. Some of the most common strategies they use to exploit their victims include:

Providing False Claims

This tactic involves presenting fraudulent claims for certain NDIS supports or services that indicate that they were not performed, provided, or delivered as described by the provider.

Colluding with Providers

Fraudsters sometimes secretly work with providers or staff members of these organisations to submit false or exaggerated claims for services that weren’t rendered.

Stealing Other People’s Identity

Identity theft involves the unlawful use of another individual’s personal information and data in order to benefit from NDIS funds and services.

Overcharging

NDIS providers that operate illegitimately can sometimes charge higher fees for certain services.

Misusing NDIS Funds

Instead of using the allocated funds according to their NDIS plan, some participants commit NDIS fraud by using the funds for personal expenses.

Submitting False Information

Participants can take advantage of the system and get more funds or benefits than they need by providing incorrect information about their condition or disability.

Phantom Billing

In this strategy, fraudulent NDIS providers charge for non-existent services or ghost employees, which are staff members who do not work for the organisation.

Protecting Yourself From NDIS Fraud

Both participants and service providers can follow certain steps in order to protect themselves from becoming a victim of NDIS fraud. Following these strategies can also help ensure the program’s integrity.

What Participants Can Do to Avoid NDIS Fraud

Understanding Your Plan

As a participant, make sure to familiarise yourself with the various details of your plan, such as the supports and services available to you. If certain aspects of your plan are unclear, get in touch with the National Disability Insurance Agency (NDIA) or your support coordinator to get more details.

Work with Registered Providers

It’s highly advisable to only work with registered NDIS providers since these organisations are required to follow and maintain certain guidelines and standards. Working with a registered service provider reduces your chance of becoming a victim of NDIS fraud.

Work with a Plan Manager

Part of a plan mangers role is to be vigilant regarding any suspicious invoicing behaviour. They are obliged to inform you the participant if they think something doesn’t look right.

Verify Credentials and Information

Before working with an NDIS provider, support coordinator, or service worker, make sure to check with the NDIA to verify their registration and credentials. This can be done through the NDIA’s website or by getting in touch with their customer service.

Maintain Detailed Records

Make sure to keep a record of your interactions with NDIS providers and support coordinators. This includes keeping copies of your invoices and receipts for the services you received through the program. Doing so helps you keep track of how your NDIS funds are being utilised. Plus, you can refer to these records to identify possible discrepancies.

Service agreements

Ensure all providers have service agreements so that there is a written and agreed record of what services are to be provided, there frequency and value.

Safeguard Your Personal Data

Always be careful when it comes to disclosing your personal information and documents related to your NDIS membership. Don’t give out your NDIS number and other details unless it will be used for a legitimate purpose.

What Providers Can Do to Avoid NDIS Fraud

Become a Registered Provider

NDIS providers can protect themselves from fraud by registering with the NDIS. Doing so ensures that their operations comply with the latest standards and regulations.

Maintain Transparency

As an NDIS provider, it is your responsibility to ensure that the information you provide to participants and the NDIA is up-to-date and accurate. In addition, you must avoid misrepresenting your services or exaggerating claims.

Keep Proper Documentation

Keep a detailed record of the services you provide to participants, payments received, and any agreements made with participants. You can also refer to these records to demonstrate the legitimacy of your NDIS business’ operations.

Check Your Services and Payments

Regularly reviewing and cross-checking the services you provide to participants with the claims they submit can help ensure accuracy. This strategy can also help prevent overcharging or false claims.

Train Your Staff Members

Conducting regular training sessions can help make sure that your employees are aware of the current NDIS rules and ethical practices, which can prevent them from making a mistake in their interactions with participants and accidentally committing NDIS fraud.

Why You Should Get an NDIS Plan Manager

In addition to the strategies mentioned above, as a participant, you can also protect yourself from becoming a victim of NDIS fraud by availing of the services of a registered, trusted, and professional NDIS plan manager.

Reliable plan managers are knowledgeable about the NDIS system. They use their expertise and knowledge to help you navigate and understand the complexities of the whole funding process.

Their service mainly involves handling the financial and administrative aspects of your NDIS plan. For instance, NDIS plan managers monitor your invoices to service providers to ensure that you don’t miss a payment. They also help prevent overspending by keeping track of your plan’s budget.

Aside from these, probably the most important service that plan managers provide is making sure that the types of support that you receive as a participant are aligned with your needs based on your condition.

By keeping track of your invoices, monitoring the services you’re entitled to, and handling the overall day-to-day administration of your NDIS plan, plan managers can help you avoid becoming a victim of NDIS fraud. If you’re looking for an NDIS plan manager that you can trust, then make sure to get in touch with AIIM Choices. We provide a personalised NDIS plan management service aimed at helping you make the most out of your NDIS plan. Our multilingual staff members and managers will not only make sure that your NDIS bills are paid on time, but they’ll also provide you with helpful advice regarding the various aspects of your plan.

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