Medical Billing Forum

Payments => Patient Billing => Topic started by: wharta on February 08, 2010, 01:57:45 PM

Title: copay out of patient responsibility
Post by: wharta on February 08, 2010, 01:57:45 PM
Should i take into account the patient copay they paid at time of service before sending out a statement for the patient statement. ( Do i deduct what they paid at time of service form the pr amount due)?
Title: Re: copay out of patient responsibility
Post by: Anand on February 08, 2010, 03:14:04 PM
If you have pt statements meant for copay which was already paid by the pt during the time of service[already posted in the DB]. I would certainly refrain from sending statements on copay's. Let's say we have to bill pt for $250.00 ded & in that service due to some exception you do not have copay but pt paid $50.00 upfront then I would sent bill for $200.00 as we have pt already paid $50.00 however I would document this cleary to avoid any further confusion in the future.

Thanks,
Title: Re: copay out of patient responsibility
Post by: wharta on February 09, 2010, 09:27:50 AM
No, I am saying that the patient paid their copay at time of service lets say 20. They owe coinsurance in the amount of 100, do i deduct that from the coinsurance owed or is that totally seperate.
Title: Re: copay out of patient responsibility
Post by: Anand on February 09, 2010, 09:32:22 AM
I think, when we say copay & Co-ins that becomes different though they are part of OOP(out of pocket expenses). If there is co-ins pending that would be treated as different. Thanks
Title: Re: copay out of patient responsibility
Post by: Michele on February 09, 2010, 11:48:31 AM
You should go by what the eob says that the total patient responsibility is, then subtract any payments made.  When a patient has a set copay, it is unusual to also have a deductible.  But in any case, if the eob says the patient responsibility is $100, and the patient paid $20 at the time of service then the patient bill should reflect that.

Michele