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, however these write-offs are not tracked.

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

  1. Create a co-payFee 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

  3. On the Edit Insurance Plan window set the following:
    • Fee Schedule: The normal fee schedule for the carrier.
    • Patient Co-pay Amounts: The co-pay fee schedule for the carrier.