EMMJ Disability Services Pty Ltd
T/A Rise and Shine Plan Management

 NDIS PACE REGISTRATION NUMBER 405 007 4839
ABN#74641015830

Service Agreement

This Service Agreement is between EMMJ Disability Services Pty Ltd trading as Rise & Shine Plan Management and the Participant and/or their Nominated Representative.

The purpose of this Agreement is to outline the Plan Management services to be provided, the responsibilities of each party, and how we will work together to support the financial administration of the Participant's NDIS Plan.

Rise & Shine Plan Management is a registered NDIS provider and will deliver services in accordance with the NDIS Act, NDIS Pricing Arrangements and Price Limits, and all applicable NDIS requirements.

Term of Agreement

This Service Agreement commences on the date it is accepted by the Participant or their Nominated Representative and remains in effect until terminated by either party in accordance with this Agreement.

By accepting this Service Agreement, the Participant or Nominated Representative authorises EMMJ Disability Services Pty Ltd trading as Rise & Shine Plan Management to provide NDIS Plan Management services and to act on their behalf in relation to the financial administration of their NDIS Plan.

If unsure, type your address here to check:  (https://www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app)

EMMJ Disability Services Pty Ltd trading as Rise & Shine Plan Management agrees to provide NDIS Plan Management services to the Participant.

NDIS Plan Management services include the financial administration of the Participant's NDIS funding, including invoice processing, claim submission to the NDIS, budget monitoring, financial reporting and other activities associated with managing NDIS funding.

The responsibilities of both Rise & Shine Plan Management and the Participant are outlined within this Agreement.

The cost of NDIS Plan Management services will be claimed in accordance with the Participant's NDIS Plan and the current NDIS Pricing Arrangements and Price Limits.

Any expenses, goods or services that are not funded under the Participant's NDIS Plan, are not compliant with NDIS requirements, or fall outside the scope of this Agreement remain the responsibility of the Participant or their Nominated Representative.

EMMJ Disability Services Pty Ltd trading as Rise & Shine Plan Management agrees to:

• Review invoices and payment requests for completeness, compliance and alignment with NDIS requirements.

• Undertake reasonable compliance, verification and fraud prevention checks, including requesting additional information or supporting documentation where required.

• While Rise & Shine Plan Management is not responsible for determining whether a support is considered reasonable and necessary under the NDIS, we are required to ensure claims submitted through our service align with the Participant's approved NDIS Plan, available funding, NDIS legislation and current NDIS requirements. The Participant and/or Nominated Representative remains responsible for ensuring that supports purchased using NDIS funding comply with NDIS funding criteria and their approved NDIS Plan.

• Rise & Shine Plan Management reserves the right to decline, place on hold, or request additional information, supporting documentation, participant confirmation, or provider verification in relation to any invoice, reimbursement claim or payment request that is not consistent with the Participant's NDIS Plan, available funding, supporting evidence, or current NDIS requirements, or where there are concerns regarding compliance, insufficient funding, missing information, suspected fraud, provider verification concerns, or other matters requiring clarification.

• Rise & Shine Plan Management is committed to supporting Participants to use their NDIS funding in accordance with their approved NDIS Plan and current NDIS requirements. Where additional information is required to determine whether a claim can be processed, we may request supporting documentation or further clarification before proceeding.

• Provide NDIS Plan Management services and financial administration of the Participant's NDIS Plan.

• Process claims and administer the Participant's NDIS funding in accordance with the funding available within the Participant's NDIS Plan.

• Submit claims from the Participant's available NDIS funding in a timely manner.

• Facilitate payment to providers and suppliers from available NDIS funding once claims have been processed and funding has been received through the NDIS payment system.

• Process participant reimbursement claims where appropriate and supported by the required documentation.

• Monitor available funding and provide statements, expenditure reports and budget information upon request.

• Provide access to the Rise & Shine participant app or portal to view funding balances, claims and other relevant information.

• Consult with the Participant and/or Nominated Representative regarding the administration of their NDIS funding when required.

• Communicate openly, honestly and professionally through email, telephone, SMS and other approved communication channels.

• Treat the Participant and/or Nominated Representative with courtesy, dignity and respect.

• Listen to feedback, address concerns promptly and provide access to our Complaints and Feedback Policy upon request.

• Protect the Participant's privacy and confidential information in accordance with applicable privacy legislation and EMMJ Disability Services Pty Ltd policies and procedures.

I agree to:

• Use NDIS funding in accordance with my approved NDIS Plan, NDIS legislation, NDIS funding criteria and any applicable budget allocations or funding release periods.

• Ensure supports and services are purchased within the funding available in my NDIS Plan. I acknowledge that I am responsible for managing my supports within the available budget and funding periods and will not knowingly incur expenses that exceed available funding.

• Monitor available funding and verify the availability of funds before engaging providers or receiving supports. I understand that supports and services must be delivered within the available funding, budget allocations and funding release periods of my NDIS Plan, and that services may need to cease or be adjusted where funding is unavailable or exhausted. I acknowledge that I am responsible for the cost of any supports or services I engage that exceed the available funding in my NDIS Plan or are not funded by the NDIS.

• Provide Rise & Shine Plan Management with a copy of my current NDIS Plan and any subsequent plan replacements, reassessments or updates.

• Complete any required NDIS consent forms and provide true, accurate and up-to-date information.

• Forward provider invoices, reimbursement requests and supporting information to Rise & Shine Plan Management as soon as practicable following the delivery of supports.

• Review and either approve or decline invoices within 48 hours of receiving notification. Where an invoice is declined, a reason must be provided. I acknowledge that where no response is received within 5 business days, Rise & Shine Plan Management may proceed with processing the invoice in accordance with this Agreement.

• Only submit invoices, reimbursement claims and payment requests that relate to supports delivered to the Participant and that are consistent with the Participant's NDIS Plan and current NDIS requirements.

• Provide bank account details and supporting documentation where reimbursement claims are requested.

• Immediately notify Rise & Shine Plan Management of any changes to my NDIS Plan, plan management arrangements, nominee arrangements, support coordinator, contact details, funding status, suspension of supports or any other changes that may impact the delivery of services.

• Cooperate with any compliance reviews, audits or requests for information from Rise & Shine Plan Management, the NDIS, auditors or other authorised regulatory bodies.

• Receive documents, notices and communications electronically

• Treat Rise & Shine Plan Management staff with courtesy and respect and communicate in a respectful manner.

• Raise any concerns, complaints or feedback directly with Rise & Shine Plan Management so that they may be addressed promptly and fairly.

• Comply with all applicable laws and not participate in, encourage or facilitate fraudulent, misleading, unlawful or inappropriate conduct in connection with NDIS funding or services.

• Notify Rise & Shine Plan Management in writing of any changes that may affect our ability to meet our obligations under this Agreement.

Payment Processing and Compliance

• Rise & Shine Plan Management will only process invoices and reimbursement claims that meet NDIS requirements, align with the Participant's approved NDIS Plan and have sufficient available funding.

• If an invoice, reimbursement claim or payment request does not meet the required criteria, Rise & Shine Plan Management may contact the provider, supplier or Participant to obtain further information, clarification or supporting documentation.

• Until the matter is resolved, Rise & Shine Plan Management may place the claim on hold and will be unable to process the payment request through the NDIS payment system.

• Where possible, Rise & Shine Plan Management will work directly with providers to resolve any issues. Participants will generally only be contacted where additional information is required, the matter cannot be resolved directly with the provider, or there is insufficient funding available within the Participant's NDIS Plan.

Rise & Shine Plan Management is not responsible for provider conduct.
Rise & Shine Plan Management is not responsible for NDIS decisions.

• As a registered NDIS provider, Rise & Shine Plan Management may be required to communicate with the National Disability Insurance Agency (NDIA), NDIS Commission, Local Area Coordinators (LACs), Early Childhood Partners and other authorised NDIS representatives in order to provide Plan Management services.

• By accepting this Service Agreement, the Participant and/or Nominated Representative authorises Rise & Shine Plan Management and its employees, contractors and authorised representatives to obtain, access, use and disclose information relating to the Participant, including personal and health information, where reasonably required to provide services, administer the Participant's NDIS Plan, process claims, comply with legislative obligations, or perform functions under the National Disability Insurance Scheme Act 2013.

The Participant and/or Nominated Representative authorises Rise & Shine Plan Management to:

• Access and review the Participant's NDIS Plan, funding information and relevant records through NDIS systems and portals.

• Contact the NDIA, Local Area Coordinators, Early Childhood Partners and other authorised NDIS representatives regarding matters relating to the Participant's NDIS Plan and funding.

• Communicate with providers, suppliers, support coordinators and other relevant parties regarding invoices, funding availability, claims, services delivered and other matters relating to the financial administration of the Participant's NDIS Plan.

• Collect, use and disclose personal information, including sensitive and health information, as required to deliver Plan Management services and in accordance with applicable privacy legislation and Rise & Shine Plan Management's Privacy Policy.

• Make administrative arrangements necessary to facilitate the processing of claims and payments through the NDIS payment system.

• Have records reviewed by auditors, accreditation bodies, regulatory authorities and the NDIS Quality and Safeguards Commission where required for compliance, registration, auditing or legislative purposes.

• Participants may be contacted directly by auditors or regulatory bodies as part of these processes

We collect and use personal information to ensure our services meet your individualneeds and will do so in accordance with EMMJ disability services Plan Managers' Privacy policy . This policy provides guidelines in the collection, use, disclosure, and security of your personal information 

This information will also be used for:

• Administrative purposes - planning your support and services.

• Disclosure of information to the NDIA, the NDIS Quality and SafeguardsCommission or other government agencies when needed.

• Disclosure of Information pertaining to the funded supports in the Participant'splan to other disability support providers in order for them to provideappropriate services.

• Where EMMJ disability services Plan Managers is required or authorised by law to disclose the Participant's personal information either with or without their or theirNominated Representative's consent
  

From the start date of this service agreement, we will automatically invoice NDIA for the plan management services we provide to you. Should NDIA amend any rates associated with this service we will automatically update our fees in line with the NDIS Price Guide. You will not be required to sign another fee or service agreement.

Providing you Plan Management Services may at times require us to communicate with your other services providers, such as, but not limited to Therapists, Support Coordinators and other general providers. By signing this agreement you are giving EMMJ Disability Services Pty Ltd permission to communicate with your other providers or people involved the access of services, regarding your financial aspects of your plan as required.

You may provide feedback through our info@riseandshinedisability.com.au email address or call our office number on 02 8279 6313 and request to speak to the Directors Elizabeth or Mellinda.

You can also make a complaint with the NDIS commission: You can do this first or you can do this at anytime:

Phoning: 1800 035 544 (free call from landlines) or TTY 133 677. Interpreters can be arranged

Or you can make a complaint on the NDIS Commission website: https://www.ndiscommission.gov.au › about › complaints

https://forms.business.gov.au/smartforms/se rvlet/SmartForm.html?formCode=PRD00-OCF Service Agreement Amendments

This Service Agreement is ongoing and will continue to apply to any replacement, reassessed or renewed NDIS Plans unless terminated by either party in accordance with this Agreement.

The Participant and/or Nominated Representative may cease Plan Management services with Rise & Shine Plan Management by providing one (1) month's written notice. Rise & Shine Plan Management will continue to provide services and process claims during the notice period, subject to available funding and receipt of all required documentation.

The Participant acknowledges that Plan Management fees may continue to be claimed in accordance with the NDIS Pricing Arrangements and Price Limits during the notice period where services continue to be provided.

Rise & Shine Plan Management reserves the right to waive all or part of the notice period at its sole discretion.

Upon cessation of services, Rise & Shine Plan Management will no longer be authorised to act on the Participant's behalf, submit claims, process invoices or access NDIS funding information. Responsibility for ongoing claim processing and financial administration will transfer to the Participant, the NDIS, or any newly appointed Plan Manager.

Rise & Shine Plan Management may update this Service Agreement from time to time to reflect changes in legislation, NDIS requirements, service delivery practices or business operations. Participants will be notified in writing of any material changes. Continued use of our services following notification of the updated Agreement will be taken as acceptance of those changes unless otherwise advised in writing within 14 days.

• Rise & Shine Plan Management is committed to assisting Participants to manage their NDIS funding in accordance with their approved NDIS Plan, NDIS legislation and current NDIS requirements.

• Rise & Shine Plan Management will facilitate the processing of claims and payments to providers and suppliers from the Participant's NDIS funding, provided that:

• The provider supplies a valid tax invoice and any supporting documentation required under Australian Taxation Office (ATO) requirements, NDIS requirements and Rise & Shine Plan Management policies.

• The supports claimed are consistent with the Participant's approved NDIS Plan, available funding, budget allocations and funding release periods.

• The supports are supported by any applicable service agreements, participant instructions or other information reasonably required by Rise & Shine Plan Management.

• The claim satisfies current NDIS funding requirements and can be processed through the NDIS payment system.

• Sufficient funding is available within the Participant's NDIS Plan at the time the claim is processed.

• Any required Participant or Nominated Representative approvals have been received.

• Rise & Shine Plan Management is unable to process claims for supports delivered by workers directly employed by the Participant unless permitted under current NDIS arrangements or otherwise approved by the NDIS.

• While Rise & Shine Plan Management undertakes reasonable compliance checks and may request supporting documentation before processing claims, we do not determine whether a support is considered reasonable and necessary under the NDIS. The Participant and/or Nominated Representative remains responsible for ensuring that supports purchased using NDIS funding are consistent with their approved NDIS Plan and current NDIS funding requirements.

• Where there is uncertainty regarding a support, invoice, reimbursement claim or payment request, Rise & Shine Plan Management may request additional information, seek clarification, verify provider information, request supporting documentation, seek participant confirmation, or place a claim on hold pending further review.

• If the required payment criteria are not met, Rise & Shine Plan Management may contact the provider, supplier, Participant and/or Nominated Representative to obtain additional information, clarification or supporting documentation. Until the matter is resolved, Rise & Shine Plan Management may place the claim on hold and will be unable to process the payment request through the NDIS payment system.

• Where possible, Rise & Shine Plan Management will work directly with providers to resolve issues relating to invoices, documentation, compliance or payment requests. Participants will generally only be contacted where additional information is required, participant approval is needed, the matter cannot be resolved directly with the provider, or there is insufficient funding available within the Participant's NDIS Plan.

Rise & Shine Plan Management reserves the right to decline to process any claim, invoice, reimbursement request or payment request that:

• Does not align with the Participant's approved NDIS Plan.

• Exceeds available funding, budget allocations or funding release periods.

• Does not meet current NDIS requirements.

• Lacks sufficient supporting documentation.

• Raises compliance, fraud prevention, provider verification or other regulatory concerns.

The Participant acknowledges that if the NDIS subsequently determines that a support, reimbursement or claim was not funded appropriately, any resulting recovery of funds, debt or repayment obligation may remain the responsibility of the Participant and/or Nominated Representative.

Information provided by Rise & Shine Plan Management is provided in good faith and based on information available at the time. As NDIS legislation, policies and operational guidelines may change from time to time, Rise & Shine Plan Management cannot guarantee the ongoing accuracy of information provided.

Any information or guidance provided by Rise & Shine Plan Management outside the scope of Plan Management services is general in nature only and should not be relied upon as legal, financial, taxation or professional advice.

Rise & Shine Plan Management will not be liable for any failure or delay in performing its obligations under this Agreement where such failure or delay arises from circumstances beyond its reasonable control, including but not limited to government actions, changes to NDIS systems or processes, system outages, natural disasters, cyber security incidents, telecommunications failures or other unforeseen events.

Audit Requirements

• As a registered NDIS provider, Rise & Shine Plan Management is required to participate in audits and other compliance activities under the NDIS Quality and Safeguarding Framework.

• Participants may be contacted by auditors, accreditation bodies, the NDIS Quality and Safeguards Commission or other authorised regulatory bodies and may be requested to participate in interviews or have records reviewed as part of these processes.

Limitation of Liability

Nothing in this Service Agreement excludes, restricts or modifies any rights or guarantees available under the Australian Consumer Law or any other applicable legislation.

Rise & Shine Plan Management provides Plan Management services only and is not responsible for:

• The quality, delivery, suitability or conduct of supports provided by third-party providers, whether registered or unregistered.

• Decisions made by the NDIS regarding funding, eligibility, claim approvals, plan budgets, plan reassessments or funding allocations.

• Any loss, delay or interruption resulting from the actions, omissions or conduct of third-party providers, government agencies, the NDIS or other external parties.

• Supports or services engaged by the Participant and/or Nominated Representative that are not funded by the NDIS, exceed available funding, exceed budget allocations or funding release periods, or are subsequently determined by the NDIS not to meet funding requirements.

To the extent permitted by law, Rise & Shine Plan Management's total liability arising out of or in connection with this Service Agreement shall be limited to the value of Plan Management fees received by Rise & Shine Plan Management during the twelve (12) months immediately preceding the event giving rise to the claim.

Rise & Shine Plan Management provides Plan Management services in good faith and relies on information provided by Participants, Nominated Representatives, providers and other third parties.

While we undertake reasonable compliance, verification and fraud prevention checks, the Participant and/or Nominated Representative remains responsible for ensuring supports purchased using NDIS funding comply with their approved NDIS Plan and current NDIS requirements.

Rise & Shine Plan Management reserves the right to request additional information, supporting documentation or participant confirmation, and may place claims on hold or decline to process claims where funding, compliance or supporting evidence cannot be verified. Any information, guidance or assistance provided by Rise & Shine Plan Management is based on NDIS legislation, policies and requirements current at the time it is provided. As NDIS legislation, policies and operational guidelines may change from time to time, the accuracy or applicability of information previously provided may be affected. Information provided by Rise & Shine Plan Management should not be relied upon as legal, financial, taxation or professional advice.

as the participant/nominated representative understand and accept all terms as set out in the above service agreement.