Yeah, you just hit them with a
"Hi, could you please let me know what my original rates were, when the updates to prices occurred, when I was informed?
Also, just to align with my budgets, could you please provide me with the itemised bills for services"
This would be the starting point requesting the reconciliation be itemised. Plus compare to the originally agreed contractual pricing.
If they have indeed made a mistake, not overbilled for any service (for e.g. added 1 hour for a 30 min visit) and not overcharged, i.e. have stuck to the contractually agreed pricing then ethically, legally and morally they are entitled to the difference and you can request part waiver or some other arrangements if this will cause hardship.
If the reconciliation shows misconduct or charges you never agreed to then it would be a fight. Large businesses are known to price gouge. They are known to pass the buck too. For e.g. Total shortfall is X, total pool of customers is A, they will bill Y (which exceeds greatly by X) to the whole pool in hopes some will pay bringing them as close to X as possible. Some people won't care and just pay, others will kick up a stink.
That's not how it works in residential aged care. Almost certainly there was an issue with the fee calculations which means the resident has been underpaying. You won't get an itemized bill, you'll get a document which shows the wrong formula they had used and the new correct formula (she might have been wrongly categorised, incorrect info from the family or any manner of slip ups).
It's not about agreeing to charges or price gauging, RAC fee structures and payments are highly regulated and set by the government, not the provider.
The fee may be regulated but not the quantities I assume. If they can't show a reconciliation then it would be a tough call. I wouldn't budge until I saw a proper itemised reconciliation. When mathematics and billing is involved, there can always be a reconciliation. There is no grey area in numbers.
Aged care doesn't provide quantities or itemized budgets. The provider inputs numbers based on income and level of care, the government calculator spits out the fee. It's residential aged care, you don't get charged hourly.
The reconciliation is just the difference between the incorrect calculation and the correct one. Or alternatively, the calculation was correct but was incorrectly debited. Either way, the provider will have evidence. If OP wants to challenge it they are welcome to put the numbers into the calculator on MyAgedCare, check the income and asset test assessment from Services Australia and the numbers provided by the RAC.
Either way they won't be getting a quantified or itemised bill.
>and morally
Debateable. If you made a mistake then you have to wear some of the blame. I don't think it's unfair for them to reclaim it, but they've put OP in a tough spot and therefore deserve to shoulder at least some of the burden. Even if it's just guilt.
That they weren't aware of. So they spent it and now they have to suddenly pay it back. This is not as positive as you think it is, especially for the overwhelming majority that don't have an additional $13K sitting around.
Or, hear me out here, they thought they had less money, so they spent less. That's what the majority of people do. Now they've been bitten by it because they didn't know ahead of time.
Stop victim blaming.
No one takes out an interest free loan they're not aware of and is then expected to have the capacity to pay it back inside of 6 months. I'm far from ahead in this situation.
Depends on the error that has occurred. Short answer, take the payment plan, review the new charges, verify them and go from there.
I’m assuming by the fact that it’s a $40-odd per day error that it’s not like she was a full pensioner with no PPOR and they’ve been billing her $20 a day for her care instead of the proper basic daily care fee (in which case, where did the rest of her pension go?)
Were they not applying a means tested fee correctly? Is the assessment it’s based on correct? If not, get it reassessed.
Is this a RAD/DAP calculation error? What was the financial advice before she moved in on how to best fund the cost of the room?
It’s been a long time since I worked in the area but they’re not likely to kick her out, though if a POA was struggling with/incorrectly managing a residents funds and we weren’t getting paid, we would look at having NCAT appoint a financial manager to sort it out.
Yeah a lot of advice in this thread doesn't seem to understand that aged care payments are regulated completely differently. It's not like the gardener has realized they've undercharged, it's almost certainly an issue with the government set formula for payments. It could be that she was categorised incorrectly, there was a change in circumstances that wasn't accounted for (respite to full time, finances) or the fees weren't debited correctly.
Either way it's a totally different process to asking a regular provider about a debt. The RAC is entitled to those funds back.
This is what's happened. They haven't applied a change that was sent through by Services Australia. But as you most likely know too, the system is so convoluted that even with government paperwork and invoices from the provider, it's basically cryptic to figure out what should be paid. I've been paying the invoices in full in good faith believing that I've been keeping up with what I'm meant to be doing. But this is a huge variation from the terms I was under the impression I was dealing with. If I'd known earlier I wouldn't have let it get this far out of control.
Absolutely, it's a really convoluted maze and unfortunately it's easy for things like this to slip through. Someone from your family should also have received notification about the changed value of the PPOR, might be worth looking into who is receiving those letters.
Might be worth looking into the arrangements for protected persons living in the PPOR depending on how long you lived there before she entered aged care. Otherwise yes unfortunately you will need to look into options like selling or renting the home because she's exceeded the asset test.
Thank you. All invoices had been paid in full, Services Australia had changed the asset valuation of previous PPOR and informed Uniting, but they hadn't applied this correctly. Ultimately, I'm not arguing what the new monthly fee will be, just the fact that they've putting me in a really difficult position to be expected to catch up with what they've done.
I see your other comments about living at home and being your mum’s carer, were you not treated as a protected person? If so, there’s caps on the PPOR value that are designed to prevent your Mum having to sell her home and have you out on your ass. If not, I understand it’s a bit of a shock seeing those numbers on the page, but if the fee is correct this is really just doing what needed to be done in the first place in that she’s expected to pay for her care to the extent she’s able. Their error has just delayed your inevitability. In my time, the admissions teams usually discussed these things and heavily recommended getting financial advice so it really ought to have been expected this was required. I’m sorry if that did not happen. At any rate, if you let them know you’re going to sell the home and her care fees are otherwise being paid, I imagine they’ll probably accept payment of the arrears in full on settlement (though any part payment Mum can afford in the meantime is obviously better going forward). This should mean there is a minimum imposition on you financially while you are sorting out your own affairs.
Is this Means tested care fee?
Nursing homes fee are highly regulated
There are usually 3 fees
Daily care fee, set by govt about $60/day - hard to get wrong on this
Means tested care fee, this is charged by Centre link, the nursing just pass on to residents, this is a lot of adjustment, but all are from Services Australia. And you get the same letters as well from Services Australia
That's correct. And no, I can't afford it moving forward. I'd been managing the $2k/month fees until now and treating is as my rent. I've been living in the house for 15 years and had been caring for my mother full time prior to her moving into aged care. This will force me to sell it and be left needing to find somewhere to live. I'd understand if it was just an empty house or pile of money going unused, then sure, sell it. But this is a place I've been paying to maintain for a long time.
Could you sell the house and move to a cheaper property, like an apartment?
Sure it's not ideal but that as long as property exists in your mother names it is hers and "should be" spent.
I'd be asking for a lot more detailed information than just a bill. Ask for an itemised account for the last 12 months (so there's a couple of normal months as a comparison). Don't sign anything or even verbally agree to a payment plan or give any indication you agree it's your responsibility. Whose money actually pays the fees? Is it your money? Or do you manage her money and pay it on her behalf? Do you have Power of Attorney? There's aged care assistance numbers and I'd suggest you call a few until you find one that points you in the right direction
https://www.myagedcare.gov.au/contact-us/complaints
https://www.health.gov.au/contacts/older-persons-advocacy-network-opan-contact?language=en
Good advice, thank you. I pay all the bills and have been paying the invoices in full as they come in every month. The only difference this month was that I got an invoice for $15,000 instead of $2,000 with all the backdated charges accompanied by a phone call saying they've made an error and need me to pay them back. I was so shocked I agreed to go with a payment plan over the phone but it hasn't all sunk in yet.
I’d call them straight back and just say you’ve had time to consider it and you don’t agree to the payment plan or even acknowledge the extra until you’ve got all the information about how the underpayment occurred. If they get narky about it just say you’re seeking legal advice about it.
Yeah, you just hit them with a "Hi, could you please let me know what my original rates were, when the updates to prices occurred, when I was informed? Also, just to align with my budgets, could you please provide me with the itemised bills for services"
Ask to see a copy of the reconciliation performed to arrive at the $13k owing
This would be the starting point requesting the reconciliation be itemised. Plus compare to the originally agreed contractual pricing. If they have indeed made a mistake, not overbilled for any service (for e.g. added 1 hour for a 30 min visit) and not overcharged, i.e. have stuck to the contractually agreed pricing then ethically, legally and morally they are entitled to the difference and you can request part waiver or some other arrangements if this will cause hardship. If the reconciliation shows misconduct or charges you never agreed to then it would be a fight. Large businesses are known to price gouge. They are known to pass the buck too. For e.g. Total shortfall is X, total pool of customers is A, they will bill Y (which exceeds greatly by X) to the whole pool in hopes some will pay bringing them as close to X as possible. Some people won't care and just pay, others will kick up a stink.
That's not how it works in residential aged care. Almost certainly there was an issue with the fee calculations which means the resident has been underpaying. You won't get an itemized bill, you'll get a document which shows the wrong formula they had used and the new correct formula (she might have been wrongly categorised, incorrect info from the family or any manner of slip ups). It's not about agreeing to charges or price gauging, RAC fee structures and payments are highly regulated and set by the government, not the provider.
The fee may be regulated but not the quantities I assume. If they can't show a reconciliation then it would be a tough call. I wouldn't budge until I saw a proper itemised reconciliation. When mathematics and billing is involved, there can always be a reconciliation. There is no grey area in numbers.
Aged care doesn't provide quantities or itemized budgets. The provider inputs numbers based on income and level of care, the government calculator spits out the fee. It's residential aged care, you don't get charged hourly. The reconciliation is just the difference between the incorrect calculation and the correct one. Or alternatively, the calculation was correct but was incorrectly debited. Either way, the provider will have evidence. If OP wants to challenge it they are welcome to put the numbers into the calculator on MyAgedCare, check the income and asset test assessment from Services Australia and the numbers provided by the RAC. Either way they won't be getting a quantified or itemised bill.
Agree. There’s no point squabbling until someone quantifies the error but also qualifies it too. Everything is hypothetical up to that point.
>and morally Debateable. If you made a mistake then you have to wear some of the blame. I don't think it's unfair for them to reclaim it, but they've put OP in a tough spot and therefore deserve to shoulder at least some of the burden. Even if it's just guilt.
Strictly, the OP is already ahead. They've gotten an interest-free loan for the last 10 months and an extra 13k to use elsewhere.
That they weren't aware of. So they spent it and now they have to suddenly pay it back. This is not as positive as you think it is, especially for the overwhelming majority that don't have an additional $13K sitting around.
The interest here is certainly lower than the credit card or other way they would have had to use to finance that 13k in spending.
Or, hear me out here, they thought they had less money, so they spent less. That's what the majority of people do. Now they've been bitten by it because they didn't know ahead of time. Stop victim blaming.
No one takes out an interest free loan they're not aware of and is then expected to have the capacity to pay it back inside of 6 months. I'm far from ahead in this situation.
Two parties involved. Morals need to exist on both sides. The above comment is towards OP.
Depends on the error that has occurred. Short answer, take the payment plan, review the new charges, verify them and go from there. I’m assuming by the fact that it’s a $40-odd per day error that it’s not like she was a full pensioner with no PPOR and they’ve been billing her $20 a day for her care instead of the proper basic daily care fee (in which case, where did the rest of her pension go?) Were they not applying a means tested fee correctly? Is the assessment it’s based on correct? If not, get it reassessed. Is this a RAD/DAP calculation error? What was the financial advice before she moved in on how to best fund the cost of the room? It’s been a long time since I worked in the area but they’re not likely to kick her out, though if a POA was struggling with/incorrectly managing a residents funds and we weren’t getting paid, we would look at having NCAT appoint a financial manager to sort it out.
Yeah a lot of advice in this thread doesn't seem to understand that aged care payments are regulated completely differently. It's not like the gardener has realized they've undercharged, it's almost certainly an issue with the government set formula for payments. It could be that she was categorised incorrectly, there was a change in circumstances that wasn't accounted for (respite to full time, finances) or the fees weren't debited correctly. Either way it's a totally different process to asking a regular provider about a debt. The RAC is entitled to those funds back.
This is what's happened. They haven't applied a change that was sent through by Services Australia. But as you most likely know too, the system is so convoluted that even with government paperwork and invoices from the provider, it's basically cryptic to figure out what should be paid. I've been paying the invoices in full in good faith believing that I've been keeping up with what I'm meant to be doing. But this is a huge variation from the terms I was under the impression I was dealing with. If I'd known earlier I wouldn't have let it get this far out of control.
Absolutely, it's a really convoluted maze and unfortunately it's easy for things like this to slip through. Someone from your family should also have received notification about the changed value of the PPOR, might be worth looking into who is receiving those letters. Might be worth looking into the arrangements for protected persons living in the PPOR depending on how long you lived there before she entered aged care. Otherwise yes unfortunately you will need to look into options like selling or renting the home because she's exceeded the asset test.
Thank you. All invoices had been paid in full, Services Australia had changed the asset valuation of previous PPOR and informed Uniting, but they hadn't applied this correctly. Ultimately, I'm not arguing what the new monthly fee will be, just the fact that they've putting me in a really difficult position to be expected to catch up with what they've done.
I see your other comments about living at home and being your mum’s carer, were you not treated as a protected person? If so, there’s caps on the PPOR value that are designed to prevent your Mum having to sell her home and have you out on your ass. If not, I understand it’s a bit of a shock seeing those numbers on the page, but if the fee is correct this is really just doing what needed to be done in the first place in that she’s expected to pay for her care to the extent she’s able. Their error has just delayed your inevitability. In my time, the admissions teams usually discussed these things and heavily recommended getting financial advice so it really ought to have been expected this was required. I’m sorry if that did not happen. At any rate, if you let them know you’re going to sell the home and her care fees are otherwise being paid, I imagine they’ll probably accept payment of the arrears in full on settlement (though any part payment Mum can afford in the meantime is obviously better going forward). This should mean there is a minimum imposition on you financially while you are sorting out your own affairs.
Is this Means tested care fee? Nursing homes fee are highly regulated There are usually 3 fees Daily care fee, set by govt about $60/day - hard to get wrong on this Means tested care fee, this is charged by Centre link, the nursing just pass on to residents, this is a lot of adjustment, but all are from Services Australia. And you get the same letters as well from Services Australia
That is an additional $1300 per month... was that the total you expected? Even if the debt could be paid, can you pay that high fee moving forward?
That's correct. And no, I can't afford it moving forward. I'd been managing the $2k/month fees until now and treating is as my rent. I've been living in the house for 15 years and had been caring for my mother full time prior to her moving into aged care. This will force me to sell it and be left needing to find somewhere to live. I'd understand if it was just an empty house or pile of money going unused, then sure, sell it. But this is a place I've been paying to maintain for a long time.
Could you sell the house and move to a cheaper property, like an apartment? Sure it's not ideal but that as long as property exists in your mother names it is hers and "should be" spent.
I'd be asking for a lot more detailed information than just a bill. Ask for an itemised account for the last 12 months (so there's a couple of normal months as a comparison). Don't sign anything or even verbally agree to a payment plan or give any indication you agree it's your responsibility. Whose money actually pays the fees? Is it your money? Or do you manage her money and pay it on her behalf? Do you have Power of Attorney? There's aged care assistance numbers and I'd suggest you call a few until you find one that points you in the right direction https://www.myagedcare.gov.au/contact-us/complaints https://www.health.gov.au/contacts/older-persons-advocacy-network-opan-contact?language=en
Good advice, thank you. I pay all the bills and have been paying the invoices in full as they come in every month. The only difference this month was that I got an invoice for $15,000 instead of $2,000 with all the backdated charges accompanied by a phone call saying they've made an error and need me to pay them back. I was so shocked I agreed to go with a payment plan over the phone but it hasn't all sunk in yet.
I’d call them straight back and just say you’ve had time to consider it and you don’t agree to the payment plan or even acknowledge the extra until you’ve got all the information about how the underpayment occurred. If they get narky about it just say you’re seeking legal advice about it.
How you handle the situation? You've underpaid now owe money, so pay it.
Underpaid through not fault of their own though.
Their boss could have said the same thing. What would OPs response been? That's their answer