Medicaid or Flat Co-Pay Insurance Plan

Set up this Insurance Plan Type when the plan pays a flat fee instead of a percentage. Insurance coverage will be 100%.

Write-offs are not tracked and production numbers may be inflated. To track write-offs, see HMO / DMO Insurance Plan with Co-pays.

On the Insurance Plan, select these options.

If insurance does not cover a procedure for some reason, and you don't expect the patient to pay, you can enter it as a write-off when you enter the insurance payment.

If a patient is required to pay a co-pay for procedures

  1. Create a co-pay Fee Schedule for the carrier.
  2. For each procedure code, enter the patient's co-pay amount. There can be just a few fees with the rest blank. If you only have the insurance co-pay fee schedule, not the patient co-pay amounts, use this equation to obtain the fee:

    Carrier Fee - Insurance Co-Pay = Patient Co-Pay