PLAN MANAGEMENT SERVICE AGREEMENT

Vivability Plan Management supports you to manage the funding in your NDIS plan. We will assist you by monitoring your NDIS budget and paying your service providers for the supports you have received.

Participant Details

First Name *

Last Name *

Address *

NDIS Plan Start Date *

NDIS Plan End Date *

NDIS Number *

Date of Birth *

Contact Phone Number *

Email Address *

Preferred Contact *

SelfAuthorised Representative

Authorised Representative/Nominee Details

Full Name

Address

Contact Phone Number

Email Address

Relationship to the Participant

Support Coordinator Details

If you have a Support Coordinator and give approval for us to speak with your Support Coordinator regardng your NDIS funding, please provide their details below.

Full Name

Organisation

Location

Contact Phone Number

Email Address

Service Agreement Details

Fees

Fees are charged in line with the NDIS Price Guide: Support Item - Capacity Building, Choise and Control.

Plan Management Fees
Plan Management Financial Administration - Monthly Fee	$104.45	NDIS Price Guide, Line Item	14_034_0127_8_3
Description	A monthly fee for the ongoing maintenance of the financial management arrangements

Prices will be subject to change without notice upon NDIS price reviews, and as such will be adjusted to come in line with the updated NDIS price Guide.

The plan management fee will be claimed directly from the NDIS each month.

Ending this Agreement

This Agreement will be ongoing and remain in place beyond your current NDIS plan end date. This will ensure an easier transition for payment of invoices from when your current NDIS plan ends, and a new plan commences. T cancel this service, we require 28 days' notice of intention to cancel.

Conflict of Interest

Vivability will prevent any conflict of interest between Vivability and Non-Vivability clients and ensure fair treatment across all participants.

Feedback or Complaints

If you are unhappy with any part of this service or wish to make a complaint, or you have a suggestion on how we can improve services, or would like to provide positive feedback contact Vivability directly on 02 6301 9502 or email: reception@vivability.org.au

If you are not happy with that outcome or you do not wish to discuss the matte with your plan manager, you may lodge a complaint with the NDIS Commission 1800 035 544 or via their website.

Please upload a copy of your NDIS plan *

Browse

Service Agreement Acceptance

I accept the commencement of Financial Plan Management services to be provided by Vivability Ltd. in accordance with the terms set out in this agreement. *

YesNo

Participant Full Name *

Participant Signature (if applicable)

Draw signature|Type signatureClear

Date

Representative or Nominee Name (if applicable)

Representative/Nominee Signature

Draw signature|Type signatureClear

Date

Provider Representative Name

Provider Representative Signature

Date

Viva Plan Management Invoicing and Goals Approval

As an NDIS Financial Plan Management service, we are required to follow NDIS guidelines when processing any invoices for payment.

We can automatically process invoices for services or supports you have received when:

We have received a copy of a signed service agreement for the support provided
You have sufficient NDIS funds available to cover the invoice
The invoice contains the required information; and
The supports provided align with your NDIS plan

Option 1: Pre-Approval for Invoices *

YesNo

I give approval for invoices to be paid where a signed service agreement is in place.

You can elect to provide details for payment of invoices from nominated providers, or for specific supports. For example, regular supports or consumables funding.

Please provide pre-approval authorisation details below.

Service Provider

Support Description