Okay, so what is a copayment or a copay? So, basically this is a specific amount that the patient provides the provider the day of service for say an office visit or materials. Often your vision plans will have a materials copay. Now, this copay typically does not get applied towards the deductible, that's important to know, should you be asked by your patient. As well as I mentioned earlier, your Optometrist is typically considered a specialist copay. Now you can find what a patient's copay is either by looking at the card, you can call the insurance company directly, you can go to their website. There is quite a few different ways that you can obtain that information, but I cannot stress to you how important it is to obtain that information before the patient comes in. Often when we look at account’s receivables, we will see that copays were not collected the day of service and it becomes very difficult to collect that revenue after the patient has already left.
Another important note, is if you accidentally over collect on the co-pay or you calculated something wrong, it's very important that you credit that patient back, even if it's one penny because if you are audited, it would be deemed that you are keeping money that was basically not yours, so very, very important.
So, let's talk a little bit of coinsurances. What is a coinsurance? A lot of times people get a little confused between the copay and the coinsurance. Again, remember a copay is an amount that is provided or paid to the provider, your doctor, that day of service. The coinsurance is an amount that the patient pays after their deductible has been met. A lot of times it's like an 80/20 split, so once you meet your t$1,000 deductible the insurance company is now going to pay 80% of that bill for you and you now owe 20% of it.
One other side note, even though we collect co-pays and what we have calculated to be the balance due for the patient, that doesn't mean that the patient will not owe any more money to us, sometimes they still do.