Private Pay Clients & Billing

Overview

Private pay billing is a core revenue function at TheKey, covering clients who pay out-of-pocket for homecare services rather than through public or insurance-funded programs. This encompasses individual client invoicing, rate management, missed-billing recovery, couples care billing, and account reconciliation. Accurate and timely billing directly affects cash flow, client satisfaction, and operational credibility — particularly as TheKey expands in competitive markets such as Vancouver and the broader Ontario senior care sector.

---

Key People

• Sharon Speirs — Primary point of contact on Sea to Sky billing disputes (2026-03 through 2026-04); led internal correspondence on billing clarifications with VCH.
• Melissa Wong (VCH) — External contact at Vancouver Coastal Health involved in Sea to Sky billing coordination [RE: Billing for Sea to Sky — 2026-03-24 — Wong, Melissa].
• Marc Atkinson — Forwarded and escalated open invoice and short-pay reconciliation issues for CDHC account [Fwd: CDHC Open Invoice — 2026-03-27].
• Shawntel Sousa — Responded on CDHC overdue/short-paid invoice reconciliation thread [Re: CDHC — 2026-03-27].
• Michelle Schefter — Investigated payment acceptance discrepancy of $2,388.63 on Invoice 1276498 for client Dr. Shanta Khoday & Dr. Tukaram [Re: Investigation — 2026-03-31].
• Brent Lakatos / Joey Taylor — Handled missed billing notification for client Barbara Payson (live-in shifts 2/13, 2/20, 2/27) [2026-03-19 and 2026-03-23].
• Halyna Chernik — Flagged a GPC invoice awaiting payment [2026-03-25].
• Amanda Ilines — Submitted strategic account plan approvals for Amica Credit Mills, Chartwell Oakville, and Amica Glen Abbey [2026-03-19 through 2026-03-25].
• Isabelle Grondin — Submitted strategic account plan for Residence Lumia [2026-04-02].
• Sheila Lively — Shared Vancouver Senior Care Sector strategic framework document [2026-03-27].

---

Processes & Policies

Standard Invoice Cycle

• Invoices are generated and sent to private pay clients on a scheduled basis; billing cycles appear to align with pay periods (e.g., Toronto Corporate Payroll Pay #7, pay date 2026-04-03).
• Invoice approvals for vendor and client-related payments route through Coupa (e.g., Lifeguard Health CAD Invoice #FebCalg approved 2026-03-26; Clark Wilson LLP wire approved 2026-03-20).

Missed Billing Recovery

• When shifts are not billed at time of service, a formal client notification process is triggered.
• Example: Client Barbara Payson was notified of billing for three missed live-in shifts (2/13, 2/20, 2/27) via a tracked support ticket [#1466877], managed by Brent Lakatos and Joey Taylor.
• Missed billing notifications must be documented with ticket references and sent to clients before charges are applied.

Short-Pay & Overdue Invoice Reconciliation

• Accounts with overdue or short-paid invoices undergo a formal review process, as evidenced by the CDHC account reconciliation [#1476584, 2026-03-27].
• Marc Atkinson and Shawntel Sousa coordinate these reviews; escalation paths appear to run through operations leadership.

Payment Dispute Investigation

• Disputed or irregular payments (e.g., the $2,388.63 acceptance on Invoice 1276498) are assigned a support ticket and investigated by billing staff (Michelle Schefter) with involvement from account managers.

Couples Care Billing

• Billing for couples receiving care is handled under a distinct intake and scheduling process, documented in Couples_Care_Intake_Scheduling_Billing.txt and its draft version.
• Couples care likely involves split or combined invoicing for two clients sharing care hours; specific rate logic is detailed in the source documents.

Annual Rate Changes

• A temporary process exists for managing annual rate changes, documented in Annual_Rate_Change_Temporary_Process.txt. This suggests rate updates do not yet flow automatically through the billing system and require manual intervention.

Strategic Account Billing

• Senior living facility accounts (Amica, Chartwell, Residence Lumia) require approved Strategic Account Plans before billing relationships are formalized, routed through a named approval process.

---

Timeline & Key Events

| Date | Event |

|---|---|

| 2026-03-19 | Missed billing notification issued for Barbara Payson (live-in shifts); Brent Lakatos responds |

| 2026-03-23 | Sharon Speirs initiates Sea to Sky billing thread; Coupa approval request issued for Lifeguard Health Invoice #FebCalg |

| 2026-03-24 | VCH's Melissa Wong engages on Sea to Sky billing; multiple clarification exchanges with Sharon Speirs |

| 2026-03-25 | GPC invoice flagged as awaiting payment by Halyna Chernik |

| 2026-03-26 | Invoice #FebCalg (Lifeguard Health CAD) approved via Coupa |

| 2026-03-27 | CDHC open invoice reconciliation escalated by Marc Atkinson; Vancouver strategic framework shared by Sheila Lively |

| 2026-03-31 | Payment investigation opened for $2,388.63 discrepancy on Invoice 1276498 (Khoday/Tukaram account) |

| 2026-04-01 | Sea to Sky billing thread continues; Sharon Speirs responds to VCH |

| 2026-04-02 | Strategic Account Plan submitted for Residence Lumia (Isabelle Grondin) |

---

Key Decisions

• Missed billing must be formally communicated to clients before retroactive charges are issued, using a ticketed notification process.
• Coupa is the approved platform for invoice approval workflows, including vendor payments and client-facing billing approvals.
• Strategic account plans are required before billing relationships with senior living facility clients are activated.
• Annual rate changes use a temporary manual process, indicating that automated rate update functionality is not yet in place — a known operational gap.
• Couples care billing follows a separate, documented intake process, distinct from standard single-client billing.

---

Open Questions & Gaps

• The Sea to Sky billing dispute with VCH (Sharon Speirs / Melissa Wong thread, 2026-03-24 to 2026-04-01) spans multiple exchanges but the root cause and resolution are not clear from available excerpts.
• The $2,388.63 payment discrepancy on Invoice 1276498 (Khoday/Tukaram) was under investigation as of 2026-03-31; no resolution is recorded.
• The GPC invoice awaiting payment flagged by Halyna Chernik (2026-03-25) has no follow-up visible in the available record.
• The Annual Rate Change Temporary Process is explicitly temporary — it is unclear what the permanent solution is, who owns that project, or what the target timeline is for automation.
• Couples care billing specifics (how hours are split, whether one or two invoices are issued, liability assignment) are referenced in documents but not fully surfaced in email threads.
• It is unclear whether CDHC is a private pay or publicly funded account; its classification affects which billing policies apply.

---

Related Topics

1. Couples Care — Intake, Scheduling & Billing

2. Annual Rate Change Process

3. Strategic Account Management (Senior Living Facilities)

4. Payroll & Pay Period Coordination

5. Client Satisfaction & Billing Feedback (Medallia)