Per Visit Co-Pays

If a patient's insurance pan requires a co-pay per visit rather than per procedure, follow these steps to set up 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. See Adding a New Procedure Code.
  2. Set up a co-pay fee schedule. See Fee Schedules.
  3. If 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.