Creating a Coverage Table for Fixed Copays

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    Irene George

    The excel sheet is a brilliant idea but it didn't solve the problem sorry 

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    Irene George

    I have one carrier PPO with Co pay but non of these worked with it 

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    Katie Nielsen

    Hi Irene, I was able to get it to work.  These instructions are set up to calculate the patient portion so you have to do it a little bit differently than is stated here.  For example:  D2391- Patient pays $75, Insurance pays $40 so the contracted fee is $115.  You would need to create the spreadsheet to show the calculation of the Insurance coverage not the patient copay.  To create that calculation you'll divide the $40 by $115 which gives you 34.783%  Its important to increase the decimal at to 3 places so the amount is right on the penny.  Then place these percentages in the coverage table template as instructed here.  Also make sure the billing provider you are using is contracted with the carrier.  

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