Thursday, March 28, 2024

answers to co-pay post

nathan keepers

Here are the answers to my original post on whether or not co-pays are being
charged by O&P providers: (No, at least by those that responded):

That’s for MD offices…

that copay is for physician’s visits.

Dear Mr. Keepers – I can’t wait to hear back, because I have been told by 2
separate insurers that we are not entitled to ask for copays since that
represents a portion of an “office visit fee” and we receive payment for
“products/services” not visits. I would love to know if the national
company asking patients for this money starts with an ?(omitted)? or not?

We do not charge the office visit co-pay, because we do not charge for the
office visit–only the item(s) the patient actually receives.

We do not fall in the copay category since we do not charge for office
visits. That is why we fall under the deductible/coinsurance category.

hope this helps

Most HMO/PPO plans do not have a copay for DME just for office visits/labs &
xrays. Verification of benefits would tell you if you need to. We don’t
because the policies here have no copay for DME.

If the patient has an office visit copay like say $10 or so then I see no
reason for it to be collected. In this day and age of discounts just to get
a contract why leave a thousand or dollars on the floor each month.

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