This is really easy. If the allowed amount for a date of service is $23.73, and the patient's co-pay is $25.00, they are only responsible for $23.73. If you services that make the allowed amount OVER $25.00, they would be responsible for the full $25.00 and the insurance should pay the rest UNLESS there's deductible to be met (which supercedes the co-pay) OR there's a co-insurance as well as co-pay. QuoteExactly, DMK
Exactly, DMK
We have been running in to this a lot lately, with co-pays being so high. We have been told by many insurances to have the patient sign a letter that the co-pay is more than the allowed amount