Change the Responsible Party and Copay for Charges

How do you change the responsible party for charges on an account, and how do you change the expected copay due for a charge?

Update the Patient’s Insurance Policies and Expected Copay

Your practice can update a patient’s policies, including their expected copay, at any time before or after charges are posted. Use the Policies component, which is found in Patient Check-In, in the Demographics section of the chart, in the Post Charges tool, and wherever else your practice decides it should be visible.

When you update policy and copay before you post charges for an encounter, they will pend the correct payer and the correct expected copay will be indicated for the visit charge.

You can also change the expected copay for any procedure as you post charges for the encounter.

When you update policy and copay after posting charges for an encounter, you will need to edit the charges so they pend the correct payer and/or edit the expected copay amount. You might also need to generate a new claim.

Change the Copay and Next Responsible Party in the Insurance Payments Tool

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

You can also select the next responsible party for any remaining amounts due on the charges.

You can select from any policy on the patient’s record, and if necessary make changes to the patient’s policies on the same screen.

Later, you can use the History tab to edit any insurance payment and make the same changes, adjusting the copay and next responsible party.

Change the Copay and Responsible Party for Posted Charges, Before You Have Received a Response

If you need to edit the responsible party and/or the copay amount for posted charges before the payer responds, use the Changing Insurance Information screen in Correct Mistakes (oops).

The oops tool allows you to change the responsible party and copay for any charge on any encounter, regardless of its status.

Open the Changing Insurance Information Screen for an Encounter

Open an account in Correct Mistakes (oops), press F4 – Insurance Status, and then select charges to view the Changing Insurance Information screen.

You can select charges by the number listed next to them in the history. Or, you can press F3 or F4 to enter a Claim ID or visit date.

The oops program will display the date, patient name, procedure, diagnosis, servicing and billing provider initials, amount charged, and amount due for each charge you selected.

Underneath each charge, you can see the current responsible party, and (if applicable) the expected copay amount.

Edit the Responsible Party or Copay Amount

You can change the responsible party or the copay amount for any charge, and you can use the function keys to quickly change responsible party for all of the charges.

Press Tab to enter the field you wish to change. In the Insurance field, use an asterisk (*) to see a list of the patient’s active and expired plans. Optionally, you can jump to a list of all plans on your system.

Remember to Generate a New Claim Afterwards: Changing the responsible part or copay on this screen does not update any claim you have already batched or submitted. You must generate an updated claim by pressing F2 – Generate Claim on the main screen in oops.

Function Key Reference for the Insurance Status Screen