NDIS
Self Managed
Allows people to choose (almost) any provider of care they see fit. In this way, self-managing your NDIS funds maximises your choice and control in accessing the care that is right for you.
Planner Managed
An option that is mid-way between Self-Managing and NDIA management. An NDIA approved plan manager can manage part or all of your NDIS funds. Plan managers are then responsible for ensuring that the providers who support you are right for your needs and sound providers of care.
SSOT is a private practice and does not offer the NDIS Agency Managed option. For more information visit the NDIS website at ndis.gov.au/families-carers or call the NDIS Hotline on 1800 800 110.
Medicare
Your child will be eligible for a Medicare rebate if they are accessing Occupational Therapy, Psychology or Speech Pathology services. You need to get a Medicare Plan from your GP or Paediatrician prior to your first appointment in order to claim the rebate. Please note that we charge a gap fee, so you will have some out of pocket expenses. The following is an outline of the Medicare rebates available when receiving either Speech Therapy or Occupational Therapy services:
Occupational Therapy (Medicare)
EPC/CDMP – Enhanced Primary Care/Chronic Disease Management Plan
- 1-5 sessions per the calendar year
ASD – Autism Spectrum Disorder Plan
- 20 sessions (one-time use)
MHCP – Better access to Mental Health Care Plan
- 10 individual, 10 group sessions per year
- Individual clinic
- Individual offsite
- Group sessions
Rules: You cannot pay the gap fee with your private health insurance. ASD and CDMP plans need to be shared across allied health providers. i.e. 5 sessions equal 5 in total across OT, Psych and Speech Therapy if your child is accessing more than one service at a time.
Private Health Insurance
Sensory SMART allows you to claim through your private health extras cover (where appropriate)
Depending on your private health fund, you may be eligible for a private health rebate from your OT or Speech Pathology sessions. In order to claim a rebate, this can be completed at our clinic at the time of payment, using our HICAPS machine. Alternatively, you can present your receipt to your private health fund and they will organise the rebate to your nominated account.
Your eligibility for a rebate and amount will depend on your specific health coverage. Private health rebates do alter and coverage may be different depending on when you purchased your private health insurance. Coverage also has annual limits that you will need to check with your private health fund.
DSS
Families are required to present their "Letter of Introduction" to Sensory Smart prior to being able to receive services or access to products through DSS funding.
Families are required to sign a form indicating a session has been attended and we then apply for the funds for that service from DSS.
Families will receive quarterly statements from DSS regarding funding balances.
Families who have previously accessed these services may be eligible for NDIS Funding .
The FAHCSIA and Better start initiatives have now been phased out and replaced by the NDIS.
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