Service Agreement

    Client details







    Parent/carer details




    NDIS plan details







    Consent

    Core OT Pty Ltd respects a Participant’s right to privacy and is committed to safeguarding any personal
    information provided to us.

    I consent to the following information being shared only as necessary (tick all those appropriate);

    Participant name and NDIS numberParticipant contact detailsBudget amountsConfirmation of serviceRepresentative’s contact details providedI agree that the details I have provided are true and correctI have read and agreed to the NDIS Service Agreement terms (included in this document).I agree for audio recording device to be used with prior consent to revisit the conversation between therapist and client for report .I have read and understood the NDIS Orientation Handbook (included in this document).

    Select All

    I understand I can give Core OT Pty Ltd permission to share my information with certain people in my plan in order for them to coordinate my services. This includes my other service providers

    YesNo

    I agree Core OT Pty Ltd can record my information so that they can provide services to me
    and have access to my plan.

    YesNo

    I understand I can give Core OT Pty Ltd permission to share my information with certain
    people in my plan in order for them to coordinate my services. This includes my other service providers.

    YesNo

    I provide consent for my NDIS records and plans to be reviewed and audited by third party auditors.

    YesNo

    I provide consent for Core OT Pty Ltd to contact my financial guardian.

    YesNo

    I provide media consent for photos or videos to be used in Core OT Pty Ltd news updates or
    articles.

    YesNo

    NDIS Service Agreement terms

    Background

    o The NDIS client has requested Core OT Pty Ltd to provide the services described within the Service Agreement.

    o The Contractor has agreed to provide the services to the practice on the terms of this Agreement from the Date
    described in the Service Agreement.

    The Practice and the Contractor agree that:

    1. Definitions

    Agreement means this document including the attached Schedule and any other schedules and annexures.

    NDIS Client means the individual who is funded by the National Disability Insurance Scheme (NDIS).

    Notice period means the period described in the Service Agreement.

    Personnel means, in the respect of the services, the person/people that the Contractor employs to provide the services,
    including subcontractors that the Contractor may engage.

    Service Fee means the amount payable with respect to the services set out in Appendix 1 of the Service Agreement.
    Fees are normally reviewed and updated annually from July 1st.

    2. Cancellation policy

    If the participant makes a short-notice cancellation, which is after 12pm the day before the service, the provider will
    charge 100% of the agreed price for the cancelled appointment. This fee may be charged against a participant NDIS
    Plan.

    For other cancellations, where the participant has provided notice of cancellation prior to 12 pm the day before the
    scheduled service, the provider will not charge a cancellation fee.

    3. Travel charges

    Core OT is a mobile service where NDIS participants receive treatment at their own home or chosen treatment location.
    Core OT may charge travel according to the NDIS which can be charged in addition to consultations fees as per the NDIS
    Price Guide. All Travel Charges are completely in line with the NDIS price guide and will be clearly stated on each invoice.
    Travel Charges are subject to change based on indexation of NDIS Fees. By agreeing to use Core OT you also agree to
    the Travel Charges that may apply.

    4. How will invoices be paid

    Core OT does not take any responsibility for insufficient funds. Invoices will be processed and claimed via the NDIS portal
    with the provided NDIS number for the client or to the advised Plan Manager. Self-Managed participants will be required
    to pay upfront at the time of their appointments using Pin Payments and claim a reimbursement with their receipt from
    NDIS. If payment is not made on time, future appointments may be cancelled until all accounts are paid in full.

    5. Procedure with receipts

    A receipt for payments can be provided upon request by the client or referrer and sent via email.

    6. Insurance

    The Practice will ensure that each health professional holds their own personal indemnity and public liability insurance.
    The Practice will also ensure that all personal indemnity and public liability insurances are renewed accordingly. All
    employees of practice have current and valid National Police Checks. No employee has had any criminal record or court
    action taken against them.

    7. Work health and safety

    The Practice is required to comply with Work Health and Safety laws to maintain a safe and healthy workplace.

    8. Variation

    This Agreement is issued without alteration, deletion, or erasure. Any variations to this agreement will be made in
    writing to the Contractor

    9. Report writing information

    Report writing may take longer than 1 hour. In this case the participant will be billed accordingly for the health
    professional’s time

    10.Changes to this Agreement

    If changes to the Services or their delivery are required, the Parties agree to discuss and review this Agreement. The
    Parties agree that any changes to this Agreement will be in writing, signed, and dated by the Parties.

    11.Ending this Agreement

    Should either Party wishes to end this Agreement they must give 1-month notice.
    If either Party seriously breaches this Agreement the requirement of notice will be waived

    12.Feedback, complaints, and disputes

    If the Participant wishes to give the Provider feedback, the Participant can talk to Core OT on email info@coreot.com.au
    If the Participant is not satisfied or does not want to talk to this person, the Participant can contact the National Disability
    Insurance Agency by calling 1800 800 110, visiting one of their offices in person, or visiting ndis.gov.au for further
    information.

    13.Treatment

    Each health professional representing Core OT is currently registered and can practice and treat patients within the
    community. Treatment from each health professional is generally effective and safe however, like any treatments there
    are benefits and risks. Your treating health professional will explain the benefits and foreseeable risks of each
    intervention. If you don’t wish to receive a certain type of treatment, please advise your treating health professional

    14.Consent to enter the property.

    If a Core OT worker arrives at your property to provide services, it’s important that they are let in. This can be done by
    opening the door to them, yelling out that they can come in or having a key left out or them. If this happens, it’s
    presumed the Core OT worker has consent to enter the property and provide services to the NDIS participant.

      If the Core OT worker is not let into the property, then the below scenarios will take place in order:

    • NDIS participant, family member and/or carer presumed to be at

    • the property will be contacted by the Core OT worker by phone

    • (Skip if self-managed) Support Coordinator to be contacted next.

    • If no one can be contacted and the Core OT worker is not able to get consent to enter the property, they will
      leave and try and organise another suitable time to visit and provide services

    • If we are unable to gain access to the property, a cancellation fee will be incurred

    15. Fees

    Prices listed in the included NDIS Fee Schedule are subject to change at Core OT’s discretion. These changes will always
    be in line with the NDIS Price Guide. If any price changes occur whilst utilising Core OT’s services, you will be notified.

    Please note:

    90-minute consultations will cover up to 60 minutes of therapy time. 60-minute consultations will cover up to 50
    minutes of therapy time. Note taking and preparation of consultation is also considered within durations.

    NDIS fee schedule

    National

    This fee schedule is in line with the ‘NDIS Price Guide’ as found on their website

    Occupational Therapy

    Sr.No.

    Consultation

    Time

    Price

    1

    Initial Consult

    60 minutes (+ 30 minutes notes)

    $290.98

    2

    Follow up consult

    50 minutes (+ 10 minutes notes)

    $193.99

    3

    Report writing

    Per Hour

    $193.99

    4

    Equipment (Sourcing and quoting)

    30 minutes

    $96.99

    5

    Resources

    60 minutes

    $193.99

    6

    Support letter

    30 minutes

    $96.99

    7

    Home modification (Quoting and scope of works)

    30 minutes

    $96.99

    8

    Communication (email and telephone)

    30 minutes

    $96.99

    Occupational Services are charged at $193.99 as per the current NDIS rates (as of 26Feb 2023)

    Above quote is subject to change based on case complexity.

    Occupational Therapy Assistant

    Sr.No.

    Consultation

    Time

    Price

    1

    Initial Consult

    60 minutes (+ 30 minutes notes)

    $130.18

    2

    Follow up consult

    50 minutes (+ 10 minutes notes)

    $86.79

    3

    Equipment (Sourcing and quoting)

    30 minutes

    $86.79

    4

    Resources

    60 minutes

    $86.79

    5

    Support letter

    30 minutes

    $43.39

    6

    Home modification (Quoting and scope of works)

    30 minutes

    $86.79

    7

    Communication (email and telephone)

    30 minutes

    $43.39

    Occupational Therapist Assistant Services are charged at $86.79 as per the current
    NDIS rates (as of 26 Feb 2023)

    Above quote is subject to change based on case complexity

    Travel charges

      (Prices are subject to change as per indexation of NDIS Fees):
      There are two costs for travel –
      Provider Travel - Labour Costs (Time) & Provider Travel - Non-Labour Costs)

    • Zone 1, 2, 3 (MMM 1, 2 and 3): Up to 30mins/$96.99 (OT) or $43.39 (OTA) or both (Provider Travel -
      Labour Costs (Time)) + $ 1 / Kms (Provider Travel - Non-Labour Costs)

    • Zone 4 and 5 (MMM 4 and 5): Up to 60mins/$193.99 (OT) or $86.79 (OTA) or both (Provider Travel -
      Labour Costs (Time)) + $ 1 / Kms (Provider Travel - Non-Labour Costs)

    • Zone 6 and 7 (MMM 6 and 7): Up to 120mins/$387.98 (OT) or $130.18 (OTA) or both (Provider
      Travel - Labour Costs (Time)) + $ 1 / Kms (Provider Travel - Non-Labour Costs)

    As per the NDIS guidelines, travel fees may apply to your location:

    • If you reside within some city areas, you will be charged up to 30 minutes of travel time per booking
      (MMM1 to MMM3)

    • If you reside within some regional areas, you will be charged up to 60 minutes of travel time per
      booking (MMM4 to MMM5)

    • If you reside within some wider regional areas, you will be charged up to 120 minutes of travel time
      per booking (MMM6 and MMM7)

    • Travel is charged at the same hourly rate as your service provided for each appointment

    Contact us if you have more questions regarding our fee schedule