Overcharged? How to complain and get money back

Mistakes with aged care charges happen. A fee might be worked out on the wrong rate, a service might be billed that wasn't delivered, or an extra might keep being charged after it stopped. The good news is that overcharged amounts can be recovered.

This guide sets out the steps, in order, for both aged care homes and Support at Home.

First, work out where the error is

There are two different kinds of mistake, and they go to different places.

• The provider charged the wrong amount. For example, a service that wasn't delivered, a price that's higher than agreed, or an extra your parent can't use. This goes to the provider, then the Commission.
• The assessed amount itself looks wrong. For example, the means-tested contribution in the fee advice letter is based on old or wrong figures. This goes to Services Australia (or DVA for veterans).

Step 1: ask the provider, in writing

Write to the home or provider. Set out:

• which charge you think is wrong, and the dates;
• why you think it's wrong;
• what you'd like them to do, such as refund or credit the amount.

Attach copies of the agreement, invoices or statements that show the problem. Every aged care provider must have a complaints process, and must give clear statements of what it charges.

Providers have to refund contributions that were overpaid. One common case is Support at Home contributions paid at a temporary rate, before the income and assets assessment came back with a lower one. If an aged care home overcharges for the room, it must refund the extra, and if it hasn't done so within 28 days of finding out or being asked in writing, whichever comes first, interest has to be added.

Step 2: get help from an advocate

If the provider doesn't fix it, or you'd like support, the Older Persons Advocacy Network has free advocates. They can help you raise the problem and speak up for your parent.

Step 3: complain to the Commission

The Aged Care Quality and Safety Commission handles complaints about aged care providers, including fees, charges and agreements. Making a complaint is free. You can complain openly, confidentially (the Commission knows who you are but won't tell the provider), or anonymously. You don't need to have raised it with the provider first, although that's often the quickest fix.

What the Commission can do:

• Support at Home: the Commission can require a provider to pay back amounts it has overcharged.
• Aged care homes: the Commission has looked into how homes charge for extras, and some homes have refunded or credited residents.

If the fee advice letter is wrong

If the problem is in Services Australia's assessment, ask Services Australia to review it. Check first that the details it used are up to date. Changes in your parent's income or assets need to be reported within the required time, and a change that lowers the fees can be backdated.

Keep good records

• Keep every agreement, fee advice letter, invoice and statement.
• Write down the date and outcome of each phone call.
• Put requests in writing, and keep copies.

Good records make it much easier to show what was charged and what should have been.

Our guides to reading a Support at Home statement and stopping extras you no longer use explain the most common problems.

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