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Thread: collecting for copays and co insurance when seen

  1. #1

    Default collecting for copays and co insurance when seen

    AAPC: Back to School
    What is your experience in charging the patient at the time of service both the copay and the coinsurance on some of the procedures? I have pulled a few of our contracts and so far Blue Cross of Illinois in the only one that does not let the doctors office do that. I would appreciate any insight anyone has. What we are experiencing is a large guarantor responsible receivable which we would like to eliminate.
    Myrna Brown

  2. #2
    Join Date
    Apr 2007


    I work for an ASC in Florida and we do collect coinsurance and/or copays for any insurance that apply at time of service with the exception of medicare patients that have supplemental insurance.

  3. #3


    Per our contracts, we are required to collect copays up front...sounds as if you may need to re-negotiate (?)

    We too had patient collection problems until I assigned one person in the billing dept full responsibilty of patient collections...from first copays through submissions to collection company. She is working out beautifully and works very hard with front office staff to collect (and we have several sites in out-pt hospital facilities that are not our employees which she also works with).

    We set forth policies that state we will not reschedule another appt until paid in full, or adequate payment arrangements are made. We have set up payment plans and sliding fees (based on Federal Poverty guidelines) in our office, which has also helped...we also try and stress credit card payments as well, and have established a link on our website just for that purpose. We also considered Care Credit...but due to our specailty, they could not set us up on those types of credit plans. All in all everything combined has helped reduce patient balances.

    Hope you find something that works!

  4. #4


    If you know what the coinsurance amount will be, you need to try and collect it upfront, providing your carrier contracts will allow you to do that. It's much easier to collect money up front when the patient is in your office than it is when you're sending them a statement they can set aside.

    If you change your office policy, be sure to make patients aware of this policy when they call to schedule appointments, by posting a new sign and by having them initial or sign an acknowledgement form that they are aware of the new policy. Then, of course, all new patients can be made aware of the policy as they call and come in.

    By doing this, you also have a much quicker opportunity to figure out who is eligible for a true hardship waiver discount and if you need to help the patient set up a payment plan that you both can live with.

    You'll soon find that you patient responsibility amounts owed will decrease on your A/R report. Being diligent in collecting up front will reward your practice tremendously.
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

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