When the bill arrives, it is easy to set it aside and assume the total is right. Most families do that once, and then they stop looking. A steadier habit is to check each bill against a plain record of the hours that were actually worked, before anything is paid. This guide shows how to do that without turning the evening into an audit.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Start with a visit log you keep yourself
Before the first visit, decide who will write down when support begins and ends. It can be a notebook on the kitchen counter or a note on a phone. For each visit, write the day, the start and stop time, and a few words about what was done, such as a walk, a meal, a bath, errands, or settling in for the night. The purpose is not to judge the helper. It is to have your own record to hold up against the bill.
Read the bill line by line
Look for the hours listed for each visit, the rate that applies to each kind of time, and any extra lines for travel, supplies, or added time. Ask what each line means if the wording is unclear. Ask whether a visit that ended early was billed as if it ran to the planned end. Ask whether evening, weekend, or holiday time is billed differently from a regular daytime visit, and where that difference is written in the agreement you signed.
Compare the bill with your log
Sit down with both papers at the same table. Mark every visit on the bill that matches a visit in your log, and mark any that do not. A missing visit is not always an error. It may have been moved, cancelled, or covered by another helper. Write your question down and send it to the office in writing, so there is a record of what was asked and when it was answered.
What usually moves the total
Most of the changes families notice come from a few things: how many hours are added in a week, whether night or weekend time is included, whether extra stops or errands are added to a visit, and whether a visit was moved or shortened. When a total rises, check which of these changed before you assume the agency made a mistake. Often a schedule shifted quietly and nobody wrote it down. Adding a line about the change to your log keeps the next bill easy to read.
When something does not match
Stay calm and specific. Name the visit, the day, and the time that do not match, and ask the office to show the record the bill was built from. A well-run office will answer that question without making you chase it. If the answer does not make sense, ask who in the office can review it and how long that review usually takes. Keep copies of everything, and if another family member shares the bill, make sure they see the same copy you do.
For a picture of what a typical day of help can include, so you know what a visit should look like on paper, see A Day of Support at Home. Questions about the person's health go to the family's doctor, and this guide is only about the paperwork.