[Dacia]

We recently had a new software installed and it automatically bills the patient their co-pay every month before we even get re-imbursed by the insurance. With our old software it would roll over to the patient when the payment was posted from the insurance. This has caused much confusion for our patients. Just wanted to find out how other providers bill patients for their co-pay.

[serina.breen@comcast.net]

What software were you using before and what software are you using now?

Best Regards,
Serina Breen
Freedom Mobility Center
586 Parker Ave - Rodeo, CA 94572
Tel 510.799.9920
Fax 510.280.0778
Serina.Breen@comcast.net

[DMEisgoodfun]

What's the software? Maybe someone out there knows a trick around it.

[Dacia]

Our old software was MedAct. Now we are using Pacware.

[Regina]

We currently use CAU, and if the reimbursement percentage is set at 100%, a bill does not go out to the patient until the EOB is posted. If the percentage on the payer is set lower, say 80%, the bill will automatically generate for the 20%.
That said, I have no problem with the co-pay going out before the claim is processed. Don't we all pay our co-pays at the doctor's office and for procedures before the claim is processed? And I am so jealous that your patients actually read their EOBs!

[jsgarner]

I was not even aware that this was allowed. So, are we allowed to receive the co-payment for an item if it turns out to be denied by medicare or any other insurance?

[HEATHER]

With Medicare it depends on the reason for denial - EOB tells you what the patient responsibility is. If it is $0 - then no, the patient would have to be refunded. But if patient responsibility is 100% then they would owe more.