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Copayment

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Copayment
In insurance, a fee that a policyholder must pay for certain covered items for which the insurance company otherwise pays. For example, a check-up with a doctor may cost the policyholder a copayment of $25, with the insurance company paying for the remainder of the cost due. A copayment is also called a co-pay and should not be confused with a deductible. It exists to discourage policyholders from abusing the insurance policy.

Copayment. If you have a managed-care health insurance plan, your copayment is the fixed amount you pay -- often $10 to $25 -- for each in-network doctor's office visit or approved medical treatment

In some plans, the copayment to see a specialist to whom you're referred is higher than the copayment to visit your primary care physician. Some plans may not require copayments for annual physicals and certain diagnostic tests.

If you see an out-of-network provider, you are likely to be responsible for a percentage of the approved charge, called coinsurance, plus any amount above the approved charge.



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If you decide to start collecting surgical copayments and deductibles in your practice before surgery takes place, it is important to institute this policy in an appropriate manner, with compassion and sufficient patient education.
In addition, the survey found that patients who have problems making a copayment were eight times more likely to suffer an adverse event.
During the four-year period studied, the number of plans requiring a copayment for a mammogram rose to 21 in 2004 from 3 in 2001.
 
 
 
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