How to Resolve Disputes with Service Providers

November 21st, 2023

The NDIS expects participants to manage themselves like a small business – asking for quotes, signing service agreements and monitoring spending.

From one person to another, participants may or may not have adequate support (informal or otherwise) to help manage these situations. But if they don’t, and a dispute situation arises, plan-managed participants will often turn to their plan manager for support.

The following process is Capital Guardians’ approach to mediation and arbitration whenever a dispute arises.

1. Listen and Document the Dispute from All Perspectives

To be a respectful independent party, take the time to hear out all sides of the story and mediate. This means making detailed notes, taking the time to review the matter with each party individually and avoid further escalation.

2. Review the Service Agreement

Ideally there would be a written service agreement to review, if not, the service agreement would be verbal or made up of other written communications (such as email or text), that need to be considered.

3. Check Available NDIS Guidance

Identify and share any available NDIS guidance or documentation that may be relevant to the discussion.

The ‘Our Guidelines’ website from the NDIS and the Pricing Arrangements and Price Limits document are great resources to start with.

All parties agree on a straightforward interpretation of available guidance.

4. Refer to Industry Standards

If there’s nothing already written and all parties do not agree at this stage of the process, it becomes necessary to apply an ‘industry standard’ approach.

This approach will depend on the nature of the dispute, but common examples include:

  • Notice for cancellations – without an existing agreement, both parties should consider the industry standard of two weeks notice (unless they agree to part sooner)
  • Late cancellations – claim 100% of the agreed fee associated with the activity from the participant’s plan, within seven days if alternative employment is not found
  • Worker no-show or service undelivered – no payment required
  • Pay rates – fees that meet industry benchmarks, (not the NDIS maximum rate for premium operators with insurance, trained, replacement carers) for the provider quality

5. Seek Middle Ground

When multiple stakeholders in an arrangement are unhappy, it’s easy for them to dig their heels in and refuse to consider compromise of any kind.

The role of the mediator should be to make each party come to the realisation that the right compromise will allow the situation to move forward, and for all parties to have a resolution that avoids them suffering any significant loss.

For instance, a support provider may need to waive a certain fee if it hasn’t been previously justified and agreed to, on the understanding the participant will have to pay that fee in the future.

6. Focus on What’s Reasonable

Sometimes people may take a stand “on principle”.

In these circumstances, it’s important to maintain a view on what’s most fair, as well as any positives that can be taken from the situation.

For instance, we will work to ensure participants have enough in their budget to afford the occasional mistake, so long as they’re only paying out what’s reasonable.

After all, there’s always the chance of disagreements arising between parties in business, it’s more important to recover and learn from them.

7. Mentor Service Providers

Mentor the service provider on ways to prevent any losses in the future, such as:

  • Billing quickly to get paid quickly and don’t build up debt (more to lose!). The service provider may even need to cease work for a participant who doesn’t have adequate NDIS funding for the purposes.
  • Setting or refining agreements – spending time setting up a service agreement can save a lot of headaches down the road.
  • Invoicing habits – creating accurate invoices and delivering them to the participant soon after a job is done is a key way to avoid disputes, as the work is still fresh in everyone’s minds.

8. Mentor Participants

Mentor the participant on ways to prevent disagreements or losses in the future.

For example:

  • Setting or refining agreements – spending time setting up a service agreement can save a lot of headaches down the road.
  • Approving habits – sometimes participants need help staying on top of their provider payments. Ideally, participants should feel confident checking support providers deliver work as agreed and at the agreed rate, before approving invoices to be paid by their plan manager on a regular basis.
  • Being a client of choice – find more tips on this subject in our blog on finding and keeping service providers.

When Things Don’t Work Out

There are repeat offenders, both participants and service providers, who do not learn or do not want to learn from mistakes.

Our process, after repeated warnings:

  • Exit the participant. Service providers who work, need and deserve to be paid. It’s their living, not a game.
  • Discourage participants from using the service provider in the future if the provider is the source of ongoing issues. Unfortunately, these problems may not be outright “fraud”, but what’s sometimes referred to as “sharp practices” and the NDIS doesn’t yet have a mechanism to deal with this.

Ross McDonald

Ross founded Capital Guardians in 2008. The original residential care payments business took around 7 years to establish itself when home care and NDIS payments were added as government changed spending from provider directed goals to consumer directed goals. Ross's previous career included PriceWaterhouseCoopers, Spotless Group, Sensis, Benetas (CFO) and MYOB (CFO).

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