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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.

  1. Create a new non-D procedure code called office visit or something similar. Check the Do Not Usually Bill to Insurance box.
  2. Set up a co-pay Fee Schedule.
  3. 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.
  4. On the Edit Insurance Plan window, for Patient Co-Pay Amount select the co-pay fee schedule.
  5. 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.

 

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