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picture1_Business Spread Sheet 30569 | Enhanced Individualised Funding Invoice Template


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File: Business Spread Sheet 30569 | Enhanced Individualised Funding Invoice Template
enhanced individualised funding invoice template submit to ifpayments psn org nz or fax 09 8350310 name of client name of agent date invoice number client agent invoice number example invoice ...

icon picture DOCX Filetype Word DOCX | Posted on 08 Aug 2022 | 3 years ago
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                                         Enhanced Individualised Funding Invoice Template
                                            Submit to: ifpayments@psn.org.nz or fax (09)8350310
        Name of Client                                               Name of Agent
        Date                                                         Invoice Number
                                   ☐Client/agent                        Invoice number example “invoice 01” then
        Payment made to            ☐Bureau who issued invoice           increasing the number for each submission.
             Client/Agent forms required one week prior to first submission and for change of bank accounts. 
                         Claims must meet all four Enhanced Individualised Funding (EIF) criteria 
         Criteria 1   It helps people live their life or makes their life better and relates  Invoice Requirements: 
                      to the client support plan and goals.                                   ☐ Date & client name
         Criteria 2   It is a disability support which is only needed because the             ☐ Service provided 
                      person is disabled and/or costs more than it would if the               ☐ Cost of the service 
                      person was not disabled.                                                Business or contractor:
         Criteria 3   It is reasonable and cost-effective, support should cost the same       ☐ Name 
                      or less than the market price for comparable things.                    ☐Phone number
         Criteria 4   It is not subject to a limit or exclusion. See purchase guidelines      ☐Address 
                      for exclusion list.                                                     ☐ GST number if applies
        Date          Purchase & description of how it meets the four EIF criteria                      Cost
                                                                                         Y Total Cost   $ 
                      If the above claims are for a support person, the following details are required:
        Full Name
        Address
        Phone number
        Relationship to client
                                                          Declaration
        I have attached copies of receipts or invoices relating to the purchases listed above. I confirm the above
        purchases are a true and accurate record of the services provided and those services were provided in
        compliance with the Ministry of Health’s policies and guidelines relating to Disability Support Services.
        Enliven has the right to decline any submissions which do not meet the Ministry of Health’s requirements
        or are not clear and readable for auditing.
                 Client/Agent Name                             Signature                               Date
                                                             Page 1 of 2
    Continued: Purchase & description of how it meets the four EIF criteria
                          Page 2 of 2
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...Enhanced individualised funding invoice template submit to ifpayments psn org nz or fax name of client agent date number example then payment made bureau who issued increasing the for each submission forms required one week prior first and change bank accounts claims must meet all four eif criteria it helps people live their life makes better relates requirements support plan goals is a disability which only needed because service provided person disabled costs more than would if cost was not business contractor reasonable effective should same less market price comparable things phone subject limit exclusion see purchase guidelines address list gst applies description how meets y total above are following details full relationship declaration i have attached copies receipts invoices relating purchases listed confirm true accurate record services those were in compliance with ministry health s policies enliven has right decline any submissions do clear readable auditing signature page ...

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