OpenEMR

Dear All,

In the patient demographics screen we can provide maximum 3 insurance provider for a patient. But how can we dettemine the percentage of payement amout from each insurance provider. For example there is a bill for 4500 for a patient. How can we split the amount with each isurance provider.

What is the meaning of CoPay in the patient insurance screen.

regards Shihab

Shihab;

I am not sure how insurances work in India, so you may have to change some things for your specifics. But the US model pays based on the primary insurer plan. You bill them for the full fees (see my advice in the Fee Sheet Writeup, but I suggest at least 50% more than you will actually be paid). The prime returns an EOB which shows the "Allowed" amount and the difference between that and your billed is entered in the EOB/Invoice area at the W as "Ins Adjust". You will see it then displays the remaining between what you were actually paid and the allowed. That is billed to the next payer and so forth.

Joe Holzer Idea Man http://www.holzerent.com

I forgot; the CoPay is any amount paid at the time of visit.

Joe Holzer Idea Man http://www.holzerent.com

Joe,

Thank you for your reply. Are you talking abount this document http://www.oemr.org/docs/FeeSheetProcess310screenshots.pdf?

And regarding CoPay I am asked is the CoPay field in the Insurance Details entry screen which is appeared in the patient demographics screen. I dont think it is the amout paid at the time of visit. Since seperate 3 CoPay fields exists for all three insuranse providers. Could you plz check?

Thanks and Regards

Shihab

Shihab;

The PDF file you listed is the Fee Sheet instructions. In the Fee Sheet you will find a "Copay" button. When clicked, it adds a line on which you can put the payments received at that visit.

The Copay field in each insurance in Demographics is a free-form field with no logic outcome, and allows you to enter a value (say if it is always $20) or any text you wish to use, as it is merely an indicator. When you factor in variable payments based on annual out of pocket and other deductibles, you can see that programming to have it predict what you need to collect is near impossible. But collection of the payment is entered elsewhere. A safe rule of thuimb is to collect whatever their insurance card says is a copay, but that is no assurance you will not have to bill for more later. Hope that helps.

Joe Holzer Idea Man 315-622-9241 im@holzerent.com http://www.holzerent.com