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Primary Care VS Specialty Copay

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Last Post by Anonymous 11 years ago

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Sirna

(@sirna)

Posts: 384

Honorable Member

Topic starter

How are offices dealing with Different Copay amounts on the same card. So 20$ copay for the primary care doc and a 50$ copay for specialty. We have a lot of patients that have multiple copay amounts on the ins card and we don't always want to change the Allocation Set to reflect this change based on the specialty type. Primary reason is other offices may not check this and change it back to the correct Allocation Set for the visit they are having.

Any help would be greatly appreciated!

Sirna

Posted : December 11, 2013 11:28 pm

angelahunsberger

(@angelahunsberger)

Posts: 290

Reputable Member

Sirna said:

How are offices dealing with Different Copay amounts on the same card. So 20$ copay for the primary care doc and a 50$ copay for specialty. We have a lot of patients that have multiple copay amounts on the ins card and we don't always want to change the Allocation Set to reflect this change based on the specialty type. Primary reason is other offices may not check this and change it back to the correct Allocation Set for the visit they are having.

Any help would be greatly appreciated!

Sirna

Hi Sirna,

This question comes up a lot. Since there is only 1 field to store the allocation set, some offices have chosen to make the main allocation set to describe the regular pcp copay then they use case management to store the information for the specialist copay. The case then MUST be attached to the appointment or visit in order for it to automatically attach the correct allocation set to the specialist visit. I have also seen where other offices use pop up alert notes. Perhaps you could store the specialist copay in an eligibility note?

Posted : December 12, 2013 4:02 am

Anonymous

(@Anonymous)

Posts: 0

New Member Guest

Our practice makes the allocation set 100% insurance in registration at the front desk. The biller that posts the payment manually changes the allocation set to reflect the correct amount at the visit level.

Posted : January 7, 2014 2:31 am

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