Copays by Hand: Billing Families on Child Care Assistance

Somewhere on the office computer lives the copay spreadsheet. It has a tab for each month, a column of family names, a column of copay amounts, and a few cells highlighted in yellow with a note to check with the director. Next to the keyboard sits a folder of assistance paperwork, some of it new, some of it from last season.

Every week, someone opens that spreadsheet, works out what each family on child care assistance owes, and then goes into the billing system to make the bill match. The billing system, meanwhile, has already charged some of those families for every scheduled day, as if nobody were helping them pay.

The spreadsheet nobody fully trusts

Ask around and you will find that nobody quite trusts that spreadsheet, including the person who keeps it. It has been edited by more than one person. Some amounts were typed in from paperwork, some were carried over from last month, and a few were fixed after a family called. There is no easy way to tell which is which.

The mistakes it produces land on families. A day the assistance covers gets charged to the family's card by mistake, and a credit follows a week later. Or the spreadsheet falls behind, gets caught up all at once, and a family receives a copay bill for several weeks they did not know they owed. For a family on child care assistance, a surprise bill is not a small thing. Families on assistance have often been through a long process just to qualify. A charge for a covered day, or a bill they did not see coming, can leave them wondering whether the program understands their situation at all.

What the office told us about the copay week

When we listened to the office at a YMCA school-age program we built alongside, we asked them to show us exactly how a family on assistance gets billed, from the paperwork to the receipt.

They told us the copay itself was not the hard part. The family's paperwork said what the copay was. The hard part was everything around it: working it out again each week, making the billing system agree with it, and catching the covered days the system charged anyway. They told us they spent real time each week undoing charges that should never have been made.

Where the copay really goes wrong

We traced the spreadsheet back to why it existed in the first place. The billing software had no idea a family was on child care assistance. To the software, that family looked like every other family, so it billed every scheduled day at the full rate.

Everything else followed from that. Because the software could not hold the copay, the copay moved into a spreadsheet. Because the spreadsheet sat outside the billing system, someone had to carry its numbers across by hand every week. Because that carrying happened by hand, covered days slipped through, and catch-up bills piled up whenever the person doing it was out or behind.

It also meant the family's bill and the family's assistance never appeared side by side. Nobody could open one account and see the whole arrangement: what the family pays, which days are covered, and what was actually charged.

Better spreadsheet formulas would not have fixed it. The root cause was that the family's assistance lived outside the place where the bill was made.

The copay, entered once and billed as the copay

The name Echo Scheduling is a promise to echo how your program already works. In an office that serves families on assistance, that means the bill has to understand assistance the way the staff already do.

So for the program we worked alongside, a family's copay is entered once and billed as the copay. Days the assistance covers are not charged to the family.

Enter the copay once. Bill the copay. Leave covered days off the family's bill.

Here is what that sounds like in practice:

• The copay amount still comes from the family's assistance paperwork. The office enters it once, instead of working it out again every week.
• The family is billed the copay, not the full rate with a credit to follow.
• Days the assistance covers are not charged to the family.
• There is a history of who changed what, so when a copay changes, the record shows when and by whom.

It was proven with the office team before it went live, using the kinds of family situations they had walked us through. You can read about how we built it.

Five questions for your copay process this week

If your program serves families on child care assistance, you can check how well your process holds up without changing anything:

• Open the copay spreadsheet and ask who last changed it, and why.
• Pick a family on assistance and compare what they were charged with what their copay should be.
• Look for credits issued to families on assistance. Each one may be a covered day that was charged by mistake.
• Ask whether the copay is entered once or worked out again each week.
• Ask how a family learns what they owe, and whether any family has received a bill they did not expect.

If the honest answers lead back to a spreadsheet and a lot of undoing, look past the spreadsheet to the billing system behind it, and ask whether it knows which families are on assistance at all.

Tell us how your families on assistance are billed today

Every program handles child care assistance a little differently, and the details matter. Tell us how your day really runs: where the copay lives, how covered days are handled and what your families see on their bill. We will listen before we show you anything. Request a demo.