It is essential to have policies for your office.

Collection of the copay is always an excellent subject to discuss when it concerns the front office.  Why is it necessary to collect copays at the time of the visit?   In some cases, insurance companies will have verbiage in their contract requiring you to collect copays when the patient presents to the office for their visit.  Therefore, knowing if a copay is to be collected is essential when you verify benefits and eligibility.

In addition, some EHR systems have a place to put the copay amount to record for future use. Collecting copays also keeps administrative costs down.  However, the cost of sending a statement, having an employee or billing service call the patient to collect payments, and sending balances to collections can add up.  These costs can be more than the amount of the copay.

Can you write off the copay?

Routinely writing off copays can violate the Federal Anti-kickback statute and the Federal False Claims Act.  It can also put you at risk of other liabilities, as with your insurance contract and state laws. The best practice is to place signs in your office about copays must be collected at the visit and reinforce that policy.  Any write-off of copays needs documentation that attempts to collect were made.  If waiving the copay is due to financial hardships, have a form that the patient can fill out with documentation of finances and extend to every patient seen in the office.