An NDIS plan manager is essentially a financial bookkeeper. An NDI plan manages all financial transactions for a plan and ensures that all funds are correctly recorded. Unlike a traditional health care plan, an NDI plan allows individuals and organizations easy access to healthcare and insurance without the hassles of complicated paperwork. With this solution, recipients can hire a qualified plan manager to manage all accounts on their behalf but still receive payouts in the number of funds they’ve earned.
While it’s true that NDI plans are more complex and require more due diligence than specific self-management solutions, getting started approval for invoices with these solutions is significantly easier. The process typically begins with a qualified candidate applying for an NDI policy. When accepted, the applicant must first complete a HIPAA-certified security assessment that verifies the organization’s security parameters. It includes a review of the system’s architecture, compliance requirements, and process for accepting and managing healthcare information. In addition, all participants in the self-management or NDI agreement must meet federal privacy and protection guidelines, including taking steps to protect personal information.
Once the application is approved, a provider-trained NDIS plan manager will then review the application. They will check for errors, access the applicable forms, check pricing guides, and conduct interviews with applicants. After carefully reviewing all information, the provider will make their recommendation to the organization’s governing board. Assuming approval, an applicant will be provided with an NDI card, which can then be used to make monthly NDI premiums payments directly to the plan.
Since most NDI plans are sold through health maintenance organizations (HMOs), the service providers must adhere to the same HMO policies as the insured or underwriters will look at when rating insurance risk. Therefore, NDI participants must be accurately matched with suitable providers. Because of this, the NDI plan manager maintains lists of providers and their proposed prices and will use these as a factor in determining if participants qualify for discount pricing. In addition, the manager will assign a fixed cost to each provider, based on invoicing and HIPAA training information, and will help ensure that each participant receives the appropriate discount pricing.
Many people think that they can self-manage their HMO plan. However, this is not a good idea, especially if the program means little more than a higher monthly bill. Although some people find the added paperwork and administrative burdens of an NDI tedious, it is worth the effort for those who have an NDI and need extra support services. However, suppose you are in a situation where self-managing might mean undercutting the quality of care and compromising your financial security. In that case, you need to seriously consider the pros and cons of NDI membership before signing up.
The primary benefit of having an NDIS is the ability to keep track of all health-related bills. An NDI plan manager keeps track of all invoices sent to the plan participant. It includes detailed information about the medical cost, the deductible amount, the covered services, the coverage amount, any coinsurance out of pocket, and any additional payments due. When a new policy or a change to a previously covered service is made, the manager will quickly review the prior bills to determine if changes were made and if a new payment is required. It allows for accurate NDI payment, which is critical to maintaining NDI participation.