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Billing Configuration: Client Co-pay prior to Insurance
Billing Configuration: Client Co-pay prior to Insurance
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Written by Kate Lewis
Updated over 4 years ago

Vocabulary

Primary—the payer who is billed first

Secondary—the payer who is billed second

Tertiary—the payer who is billed third

Quaternary—the payer who is billed fourth

Quinary—the payer who is billed fifth

Remainder Payer—the payer who receives the remainder (whatever is left over) after all other payers have been assigned their portion of the bill

Per Diem Allowance—an amount per calendar day that a payer is willing/required to pay

Difference—a percentage or dollar amount of the total invoice that a payer is willing/required to pay

Visit-- an amount per visit that a payer is willing/required to pay

Weekly--an amount per week that a payer is willing/required to pay

Monthly-- an amount per calendar month that a payer is willing/required to pay

Client Authorization-- an amount per day/week/month/year that is pre-approved by the payer and should not be exceeded in scheduling


Process

Go to Client>Payers and create a NEW payer that has the client’s name with “co-pay” as part of the name

Once you have the Payer in your portal, navigate to the Rates tab of the client profile and select + Existing Payer to add client co-pay

Start typing the client's name in the Name field, select the correct one from the options, and then choose search

Choose select to open the Client Payer configuration window

When the Add Client Payer page opens

  1. Select Primary as the Rank

  2. Select the appropriate Payment Distribution for what the client needs to pay

Per Diem Allowance—an amount per calendar day that a payer is required to pay

Difference—a percentage or dollar amount of the total invoice that a payer is required to pay

Visit-- an amount per visit that a payer is required to pay

Weekly--an amount per week that a payer is required to pay

Monthly-- an amount per calendar month that a payer is required to pay

3. Save the Client Co-Pay payer

To add the insurance payer with authorizations, go back to the top and select + Existing Payer

Enter the Insurance payer in the Company Field and click search

Choose Select

When the Add Client Payer Page Opens

  1. Select Secondary as the Rank

  2. Enter the Member ID #

  3. Select Client Authorization as the Payment Distribution

4. When the window opens, enter the information for the authorization and save

If there is another authorization for the same payer, you can add it by clicking the +Authorization button

When all auths have been added, select the correct Claim File Indicator Code and Billing Type, and then click Update

NOTE: You must always have 1 payer set to the be the “Remainder” payer. By default, that will be the client, but you can always make the last payer in the list of multiple payers the remainder.

For help with other Billing Configurations, see these articles:



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