You asked for six hours of help on Monday, Wednesday and Friday. The quote shows six hours each time. That still does not tell you whether six hours is the entire billable unit.

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.

An office may need an assessment, an introduction, a supervisory visit or a meeting after the work starts. A direct hire may expect payment for orientation, planning or a trip to the house when the shift cannot proceed. The cost question is not whether those events are reasonable. The question is whether each one is included, optional or billed separately.

Use this sheet before you compare totals. The five-step hiring sequence separates agency hiring from direct hiring because the person who employs and supervises the caregiver changes with the lane. The questions below work in either lane, but the person responsible for answering them will be different.

1. Put the scheduled shift at the top of the page

Write the schedule exactly as you gave it. Do not write “three mornings.” Write the start time, end time and tasks for each block.

Scheduled blocks: ____________________________________

Tasks inside those blocks: ____________________________

Then ask: “If every shift runs exactly as written, what time or visit outside those blocks could still be billed?”

Listen for a list. “There should not be anything else” is not a list. Ask the caller to go through assessment, introduction, supervision, family meetings, schedule changes and canceled arrivals one at a time.

2. Separate the assessment from the first shift

Ask these questions in order:

  1. Is there an assessment before service starts?
  2. Who attends it?
  3. Is it done by phone, video or in the house?
  4. Is any part of it billable?
  5. If we do not hire after the assessment, is anything owed?
  6. If the needs change and another assessment is required, is that included?

Write down: Assessment format ____________________ Billable or included ____________________

Do not accept “the assessment is free” as the end of the answer. Ask whether travel, paperwork or a later reassessment is treated the same way.

Walk away from the comparison until you get a clear answer if the caller cannot say whether the assessment can appear as a charge.

3. Ask who pays for the caregiver introduction

An introduction can mean several different things. It may be a short meeting before the shift, the opening minutes of the first shift or a separate visit involving an office employee and the caregiver.

What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).

Ask: “When the caregiver first meets my parent, has the paid shift already started?”

Then ask:

  1. Does the caregiver clock in before entering the house, at the door or after the introduction?
  2. Does an office employee attend?
  3. Can two workers be billed during the same introduction?
  4. If the match is rejected, is another introduction billed?
  5. If the assigned caregiver changes, does the same rule apply again?

Write down: The billable clock starts ____________________

Number of people who may be billed at once ____________________

The answer to listen for names the event, the clock and the number of workers. “We handle all of that” does not tell you what reaches the bill.

4. Name every visit made by someone who is not the regular caregiver

Ask the agency: “After service starts, who else may come to the house?”

Read this list aloud:

  1. A supervisor observing the work
  2. A coordinator changing the written routine
  3. A second caregiver learning the shift
  4. An office employee responding to a complaint
  5. A replacement being introduced
  6. A worker collecting paperwork or equipment

For each possible visitor, ask whether the family pays for the visit, whether the regular caregiver remains on the clock and whether both people can be billed at once.

Visitor: ____________________ Reason: ____________________ Included or billed: ____________________

If you are hiring directly, use the same list for any paid trainer, payroll service or person helping the new caregiver learn the house. The agency and direct-hire lanes place recruiting, supervision, payroll and replacement work on different desks. Put a name next to every job before assuming it is included.

5. Price the meeting before you schedule it

A family meeting can expand from a quick handoff into a separate block of paid time. Before arranging one, ask:

  1. Will the caregiver be paid for attending?
  2. Will an office employee also be billed?
  3. Is there a minimum billable block for the meeting?
  4. Does phone or video attendance follow the same rule?
  5. Can the discussion occur during the scheduled shift?

Write down: Meeting participants ____________________ Billable time ____________________

Keep health decisions with the family and the appropriate clinician. Use the hiring meeting to settle the work inside the shift, including meals, laundry, errands, personal help, notes and medication reminders.

6. Test what happens when the worker arrives but the shift cannot start

A cancellation rule may not answer every arrival problem. Ask what happens if the caregiver reaches the house but:

  1. No one answers the door.
  2. Your parent refuses to let the caregiver enter.
  3. The family sent the cancellation to the wrong person.
  4. The caregiver was given an old access instruction.
  5. The family asks the caregiver to leave early.
  6. The office sends a worker after the family believes the shift was canceled.

For each case, ask whether the charge is based on travel, arrival, clocked time, a minimum block or the entire scheduled shift.

Write down: An arrival becomes billable when ____________________

Notice must go to ____________________ by ____________________

Walk away from the comparison until the provider can identify who receives a cancellation and what proof shows it was received.

7. Ask for one complete example without asking for a price

You do not need a dollar amount to expose the billing structure. Give the caller this example:

“The caregiver is scheduled for six hours. A supervisor attends the opening half hour. The family asks for a short meeting at the end. Tell me how many people have billable time and which minutes count.”

Write the answer as separate lines:

Caregiver time: ____________________________________

Supervisor time: ____________________________________

Meeting time: ____________________________________

Other billable time: ________________________________

Ask the same example of every provider. You are comparing what creates a charge, not comparing a polished description of service.

8. Match the spoken answer to the written paper

Ask where each answer appears in the service agreement, rate sheet or policy attachment. Record the page and heading.

Assessment rule: page __________ heading ____________________

Introduction rule: page __________ heading ____________________

Supervisory visit rule: page __________ heading ____________________

Meeting rule: page __________ heading ____________________

Arrival and cancellation rule: page __________ heading ____________________

If the caller says a visit is included but the paper leaves it open, ask for written clarification before you sign. If the paper controls and the caller will not reconcile the difference, stop the comparison there.

9. Finish with one sentence the office can confirm

Read this back:

“Outside the scheduled caregiver hours, the only events that can create billable time are ____________________________________.”

Ask the provider to correct the sentence and send the final version with the quote. For a direct hire, put the sentence in the written work agreement and review it with the worker.

The site’s public source inventory includes the government and nonprofit hiring pages used across these sheets. The desk’s method is to put the source beside the factual claim and leave company claims to the company’s own written paperwork, as explained in How We Write the Sheets.

The page you should have when the call ends

Your completed page should name the scheduled blocks, every possible visitor, when the clock starts, whether two people can be billed at once, what happens after an unsuccessful arrival and where each rule appears in writing.

If any line is blank, the next move is another question. Do not fill the blank with an assumption.