If a zero ($0.00) or positive amount is found in the Co-Pay for Patient field on the Insurance Maintenance window, the defined amount will be the patient’s co-pay for all encounters.
If the Co-Pay for Patient field is blank, the system continues to the next step in the hierarchy to derive the co-pay amount.
Note: The Co-Pay for Patient override field on the Insurance Maintenance window is available only if the Display override policy number and co-pay option is selected on the Defaults-2 tab of the Payers master file. This allows a patient level co-pay amount to be entered that overrides the subscriber/policy holder level co-pay amount.
The policy holder parent may have a co-pay amount that is different from a dependent child that is covered under the policy.
