Skip to main content

CoPayments not deducting when submitting claims




  • Official comment

    Hi Trecia,

    I'd be happy to help with your question. The insurance companies assume that the copay is being paid up-front, so they are only concerned with the total session fee being billed for the date of service.

    Please let me know if you have any additional questions, and I’ll be glad to assist you.


    Comment actions Permalink
  • Katie Johnson

    So if we don't confirm the copayment amount and list that in their insurance information, then we miss out on collecting the copayments?

    Comment actions Permalink
  • Ruth

    Hi Katie - You'll want to enter your client's copay in their Billing and Insurance tab. Here is how to enter a copay for your client: Copay/Coinsurance

    If you're enrolled in Payment Reports (electronic EOBs or ERAS) through SimplePractice, then your clients' copayment amount will update when the insurance payer indicates payment has been made for billed services. This will generate Fee Adjustment Invoices, charging your clients their correct copayment amounts. Here is more information on Payment reports (ERAs).

    To clarify, when a claim is created, the billed amount on the claim won't deduct the copayment amount. The insurance payer will know how much to pay and deduct the copayment amount themselves. 

    Comment actions Permalink

Please sign in to leave a comment.