Copay Percentage
complete
Tyson Edwards
complete
Tyson Edwards
in progress
Hello, we have added a coinsurance field to the insurance section of the client profile.
If a coinsurance is entered, it will NOT use the copay amount to determine the client responsibility on the invoice. It will use the coinsurance amount.
Can you all check it out and make sure it's working as expected?
Note: We understand there is still a need for the ability to set coinsurances by service. We will tackle this next.
Dr. Zachary Causey
Tyson Edwards: anyway to work with the invoice populating both copay and coins, being that some patients have both? Other than manually editing the invoice.
Tyson Edwards
Dr. Zachary Causey: We are still researching this, so you would schedule a service and it may use the copay for that service charge. Then there would be another service that would use the coinsurance for that service charge on the same appt?
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Dave G
Tyson Edwards: My practice manager pointed out a snag in the use of this feature -- the % copay tends to be not a percentage of the billed amount, but of the insurance plan's allowed amount. So we charge $200 for a psychotherapy session but insurance might only allow $160, so the copay would actually be $160 * 20%.
I can't think of any smooth way to handle that programmatically.
Tyson Edwards
Dave G: Good call. Would it be more helpful to provide a place to set allowed amounts by payer or just provide some sort of calculator?
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Dave G
Tyson Edwards: Oo, nice idea. If we could set allowed amounts for each code per-payer, that would solve the problem.
Tyson Edwards
Dave G: Ok, we can look into. Would allowed amounts come into play anywhere else than the coinsurance equation?
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Dave G
Tyson Edwards: Hm... not that I can think of. The only place it should matter is in calculating copays and income.
Tyson Edwards
Dave G: Hello, there is a place to add allowed amounts now in the payer settings. Would you mind giving this a shot? We will be working on a way to enter different copay and coinsurance amounts by code from the client profile.
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Dave G
Tyson Edwards: In most cases this seems to be working well! My billing coordinator reported one instance where the copay amount that came up didn't match 20% of the allowable amount for that service. She's monitoring for more examples of that
Tyson Edwards
Dave G: Thank you so much for following up! That is good to hear. Yes, please email any examples to me at hello+tyson@intakeq.com. Thank you!
We are working on being able set a copay and coinsurance amount by code as well.
Tyson Edwards
We will have a way to set a coinsurance as a percentage. Is that what you are asking for here?
Dr. Zachary Causey
Tyson Edwards: we also have some insurance plans that utilize both copay and a coinsurance. The ability to have two separate fields would solve that. For example, a patient has a $15 copay plus 20% co-ins we would need two separate fields. We also have some patients that have two different copays for different services rendered: for example, they may pay a $10 copay for exams and then a $20 copay for therapy. Maybe it would also be beneficial to have a check option to have the copay/coinsurance be for all charges or have the ability to tag certain copays to certain charges.
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Dave G
Dr. Zachary Causey: Agree with this, ability to set copay amount and/or percentage would do the trick for most use cases; if you wanted to get extra fancy you could add copay amount/percentage fields to the pricing schedules that would override the main ones.
Tyson Edwards
planned
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Ryne Evans
Tyson Edwards any update on this? This is a really crucial thing for insurance based practitioners. The workaround with a pricing schedule is too much of a frustration.