Change the Copay Due on a Charge After Charges are Posted

When you learn that a patient was charged the wrong copay for a visit, how can you change the amount due? You may be trying to manually post an insurance payment and find yourself unable to do so because the copay amount for the office visit procedure is incorrect.

Full Documentation: This is a quick reference guide to a common problem. For more details, read Change the Responsible Party and Copay for Charges.

Contents

1 Change the Copay As You Post Insurance Payments
2 Change the Expected Copay for Posted Charges Before You Receive a Response

Change the Copay As You Post Insurance Payments

As you post insurance payments and adjustments, you can change the copay amount if (for example) the payer’s response indicates a different expected amount.

When you save, PCC EHR will automatically unlink personal payments down to the new expected amount, if needed.

Change the Expected Copay for Posted Charges Before You Receive a Response

If you need to change the expected copay after you have posted charges and before you submit a claim, you can change the copay for any charge using the procedure below.

Open the Correct Mistakes (oops) Program for the Patient

If you are trying to post an insurance payment and a copay is wrong, for example, you can jump into oops by pressing F6 – Correct Mistakes.

Or, you can run Correct Mistakes (oops) by family or by patient.

Locate the Charge with the Incorrect Copay

The Correct Mistakes (oops) account history is sorted by encounter date. Page down until you find the correct date, and then identify the charge that has the incorrect copay amount. Typically, copays are associated with office visit billing codes.

Press F4 and Select the Encounter or the Charge(s)

Press F4 – Insurance Status, and then enter the number next to the charge(s) you need to edit. You can also press F3 or F4 to select charges by Claim ID or the encounter’s date of service.

Change the Copay Due for the Visit Procedure

Press the Tab key to move between fields. Update the Copay field to reflect the correct amount due.

Typically, you would not change the pending insurance for the charge at this time. Policies often list a copay amount, and that copay amount may be wrong, but you should fix that in a later change to the patient’s policies unless the claim has not yet been submitted.

Press F1 to Save

Press F1 – Save to save your changes. If you were in the middle of posting an insurance payment, you can press F12 to back out to the Post Manual Insurance Payments (pip) program.

Review and Update the Patient’s Policies

You’ve fixed the charges for that encounter. However, if that specific charge had the wrong copay, does that mean that the patient has the wrong insurance policy on their account? Maybe an insurance policy is misconfigured, or many patients have the wrong copay assigned.

Review the patient’s policies and double-check that they have the correct copay. If the wrong copay was charged because the policy has an irregular copay rule (like charging a copay for well visits), you could work with PCC Support to adjust your policy configuration settings so the correct amount is charged by default at future encounters. You may also need to update the insurance policy for other patients.

Here are some related articles in Billing and Practice Management > Edit Charges and Encounter Claim Information:

Edit Encounter Charge Information and Generate a New Claim
Use the Correct Mistakes (oops) program to review an account's charge history, adjust the responsible party for a charge, change charge and encounter information, resubmit claims, and link or unlink payments. Correct Mistakes is part of PCC's under-the-hood Practice Management window (Partner).
Change Diagnoses, Hospital, or Other Claim Information After Charges Are Posted
If you need to update the diagnosis, hospital, or other visit information for a visit, follow the procedure below. Remember that you will also need to rebatch (or reprint) the insurance claim when you are finished.
Adjust Charge Details and Claim History (Correct Mistakes)
When you need to fix charge and claim details, change the responsible party for an encounter, or alter encounter information that appears on a claim (such as diagnoses or prior authorization numbers), use the Correct Mistakes tool in the Practice Management window. After you make changes, you can resubmit claims. You can also use oops to research the billing and payment history for each encounter on an account.
Edit an Encounter’s Diagnoses, Billing Provider, and Other Claim Information
Your practice can enter a diagnoses, adjust the billing provider, and add other claim information when you Post Charges in PCC EHR. If you need to make changes later (and resubmit a claim), use the Visit Status screens in Correct Mistakes (oops) in the Practice Management window. You can change diagnoses, the billing provider, and adjust other important encounter information for a charge.
Assign a Billing Provider After Charges are Posted
You may need to assign a billing provider to a charge or a visit after it has been posted. You can change the billing provider for a previously-posted charge on the Visit Status screen in the Correct Mistakes (oops) program.
Unlink and Relink a Payment
If you post a payment and later discover the procedure or payment was a mistake, you may need to "relink" the payment to different procedure.
Change the Responsible Party and Copay for Charges
Your practice can adjust the responsible party for a charge and edit copay amounts when you Post Charges in PCC EHR. If you find out the patient's policy has changed, you can edit the charges later in Correct Mistakes (oops), found in the Practice Management window. You can change the responsible payor for any charge on any encounter, and change the portion of the charge that is the copay.
Enter and Review Encounter Visit Notes
You can add and review visit notes for an encounter in Correct Mistakes (oops).
Add an Attachment Code to a Claim
If a secondary insurance requires the EOB from the primary, or any claim requires a certificate of medical necessity, discharge summary, or other clinical documentation, you can add attachment codes to a visit’s charges, generate a unique attachment ID, and specify the attachment type and method.
Change an Encounter’s Billing Place of Service After Posting Charges
You can adjust an encounter’s place of service when you Post Charges in PCC EHR. Sometimes you need to change the billing place of service of an encounter after the charges have already been posted. Read below to learn how to change the billing place of service of a phone note, portal message, or visit […]

Change the Copay As You Post Insurance Payments

Change the Expected Copay for Posted Charges Before You Receive a Response

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