Author Topic: What to do when insurance company processes different copay amount  (Read 1754 times)

Alice Scott

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Question
My doctor's office collects copays up front, before the patient is seen.  According to our contracts with various insurance companies, we are supposed to collect a copay from the patient at the time of the visit.  When the insurance company processes the claim, they do not apply a copay amount, (they pay the contracted amount in full), or they apply a different dollar amount for the copay.  What do I do?
Deb K

Answer
How about lunch?

Just kidding.  Copays are suppose to be collected at the time of service.  Itís possible the specific services being performed donít require copays.  If the EOB shows that no copay is due I would refund the copay back to the patient, or credit it to the next visit.  Insurance companies just keep finding more ways to make our jobs difficult!

Good luck
Michele

Response
thanks!  lunch sounds better... what a hassle, then the patient doesn't understand that next time there might be a copay!
thanks for your quick response!
have a great day!!!
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