A deposit or prepayment changes what a household pays before the first visit, and it sets how much money is tied up if the arrangement ends early. Read the deposit line as a cost driver in its own right, not as an administrative formality.
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Name each prepaid item
Write down every amount that must be paid ahead of service. Common items are a registration or intake charge, a block of reserved hours, a supply or equipment charge, and a standing deposit held against the account. Ask the office to label each item as refundable, credited against future visits, or kept by the agency. An item with no label is the one most likely to become a dispute later.
Check the reserved hours
Some agencies hold hours for a household even in weeks when no visit is scheduled. Ask whether reserved hours are billed whether or not they are used, how much notice is needed to release them, and whether unused hours carry forward or expire. Compare those answers with the schedule in the written care plan. If the plan calls for a short weekly visit, a large reserved block is a cost driver the household pays for without receiving the visits.
Ask about the refund and notice clock
Put three questions to the office in writing. First, when the refund clock starts: at signing, at the first visit, or on the day notice is given. Second, which party must send the notice, and in what form. Third, what happens to a prepaid balance if the arrangement ends for any reason, including a move to a different home, a change in the household's needs, or a change in the family's plans. Also ask how long a refund takes and whether it is paid by check or by credit to the account. Get every answer in the same document as the agreement, not in a phone call.
Test the cash flow over the first three months
List every amount that will leave the household account in the first three months: the deposit, the first invoice, any supply charge, and the notice period at the end. Mark which items fall in the same billing cycle, so that the household is not surprised by two large debits in the same week. Note whether the agency bills in advance or after visits are delivered. An invoice paid after service carries a different risk than one paid before the first shift, and the household should know which one it is accepting.
Questions to put to the office
Which items are paid before service starts? Which items are refundable, and which are kept? When does the refund clock start, and who stops it? How much notice releases reserved hours? Does a prepaid balance carry over if the schedule changes? Who holds the deposit, and is it kept apart from the agency's operating funds? Does the refund arrive with an itemized statement that matches the visit log?
What to do with the answers
Put the answers on one sheet beside the agreement and the written estimate. If two agencies give different answers, count the one that requires more money up front as the higher cost of the two, even when its schedule terms look lower on paper. Households comparing agencies in St. Charles County and west St. Louis County can use the same sheet for each office, so that the comparison rests on the same lines in every case.