Enter a Co-Pay Amount
On the Detail tab in the Insurance Maintenance window , there are several fields available for co-pay amounts. The amount entered indicates the patient's co-pay for the insurance, and the patient is responsible to pay that amount on encounters the insurance is linked to.
- Access the Insurance Maintenance window for the patient's insurance.
- Select the Detail tab.
- In the lower-right section of the window, enter a co-pay amount in the appropriate fields, as indicated below.
Enterprise-Level Co-Pay
In the Co-Pay Amount field, enter a dollar amount, or select a pre-defined co-pay amount from the drop-down list. This will be the patient's default co-pay for all encounters in all practices in the enterprise.Note: The enterprise-level Co-Pay Amount field is available only if the Enable practice payer specific information option is not selected in Practice Preferences > Chart. This allows all practices to use the same co-pay amount for the same patient/insurance. For example, all practices are the same type of specialty.Practice Level Co-Pay
In the Co-Payment field, enter a dollar amount, or select a pre-defined co-pay amount from the drop-down list. This will be the patient's default co-pay for all encounters in the current practice.Note: The Practice Level Co-Pay Amount field is available only if the Enable practice payer specific information option is selected in Practice Preferences > Chart. This allows each practice to define a different co-pay amount for the same patient/insurance. For example, the family practice co-pay amount may be different from the specialty practice co-pay amount.Encounter-Level Co-Pay
In the Enc Co-payment field, enter a dollar amount, or select a pre-defined co-pay amount from the drop-down list. This will be the patient's co-pay for the current encounter only. It overrides the enterprise-level or practice-level co-pay amount used for all other encounters.Note: The Enc Co-payment field is available only if the Enable encounter payer copay option is selected in Practice Preferences > Chart.Insurance Override Co-Pay
In the Co-Pay for [Patient Name] field, enter a dollar amount, or select a pre-defined co-pay amount from the drop-down list. This will be the patient's default co-pay for all encounters in the practice.Note: The Co-Pay for [Patient Name] field is available only if the Display override policy number and co-pay option is selected in the Payers master file > Defaults-2 tab. This allows a patient level co-pay amount to be entered that overrides the subscriber/policy holder level co-pay amount. For example, the policy holder (Parent) may have a co-pay amount that is different from a dependent (Child) that is covered under the policy.Copay Exempt
If a specific encounter should not have a co-pay, select the Copay Exempt check box. The Enc Co-payment field defaults to $0.00 and all co-pay fields become grayed-out and unavailable. This will be the patient's co-pay for the current encounter only.
- To save changes and close the window, select OK.