Posting Co-Payments

Payment codes assigned as co-payments are handled differently than personal payments or insurance payments.

You can review how your payment codes are set up in Review a Payment Code or edit them in Maintain Payment Codes.

A Co-payment differs from a personal payment and an insurance payment in the following ways:

• A co-payment is the portion of the visit that the patient is obligated to pay, depending on the insurance company's requirements.
• A co-payment is not handled like a personal payment, which is deducted from the patient balance, because a co-payment is typically posted before a claim is sent to the insurance company. If the system deducted the co-payment from the patient balance, then there would be a credit in the patient balance on that transaction. Therefore, the co-payment is deducted from the insurance balance since the insurance is not liable for the co-payment portion.
• A co-payment is not handled like an insurance payment in that you cannot access the Allow, Adjust or Deny columns when posting a co-payment.
• Also, a co-payment does not have any affect on the filing status of a claim. Insurance payments either cause a claim to go to the subsequent insurance, or force the balance to the patient. A co-payment will not affect the claim or the balance in these ways.

You can also enter co-payments through the Patient Check In/Out function. These are stored as Unposted Payments.

On the Payment Allocation screen, the co-payment amount automatically defaults to the co-payment amount entered in the patients insurance record. If you enter a Payment Code that has the Insurance Payment Type set to Copayment and the Performing Doctor stored for the procedure is set to Specialist, if a Spec Co-Pay amount is not stored on the patient’s primary insurance policy, the amount stored for the regular Co-Payment Amount will populate.

If you do not allocate the entire co-payment, you will receive a message stating 'The amount of $ #.## will remain unallocated. Do you want to post this payment?' Click Cancel if you want to continue allocating the payment or click OK to save this payment.