Per Visit Co-Pays
If a patient's Insurance Plan requires a co-pay per visit rather than per procedure, follow these steps to setup the plan.
- Create a new non-D procedure code called office visit or something similar. Check the Do Not Usually Bill to Insurance box.
- Set up a co-pay Fee Schedule.
- In the carrier's fee schedule is 'normal' (in-network), enter the co-pay as the fee for the procedure code in both the carrier and the new co-pay fee schedules.
If the carrier's fee schedule is 'out of network', enter the co-pay as the fee for the procedure code in the carrier, the new co-pay, and the UCR (office fees) fee schedules.
In this scenario you may need to create a different procedure code for each carrier.
- On the Edit Insurance Plan window, for Patient Co-Pay Amount select the co-pay fee schedule.
- Add the new Procedure Code (office visit) to each scheduled Appointment for patients with this insurance.
Feature Request #2073 would make this process take less steps.