How do I bill a patient/client for the co-pay, co-insurance or deductible while the claim is still being processed?

While waiting for a claim to process, providers are able to add an "estimated insurance payment" amount to the billing area. The balance will then reflect the estimated amount that the patient will owe. To do this, follow these steps:

1. Go into a patient's chart through the ''Charts'' tab or by using the ''Shortcuts'' menu on the home page.

2. Click on ''Billing'' All Transactions>Add Transaction and enter in the transaction's details as per the services rendered.

3. On the ''Payment'' field, select "Estimated insurance payment". 

  • In the “Payment comment” section, you can write "Subject to change" or something similar.
  • If you are not sure what amount to enter, check in Charts>Profile>Demographics - you likely entered the info there when you checked insurance eligibility.  We recommend you enter this info in the "Critical info" area of Charts>Profile>Demographics so you can always see it!
  • Here's how to check co-pays in the ApexEDI portal.
  • For example, if you have billed $100 for a session, and the patient's co-pay is $10, enter $90 for "estimated insurance payment" - then the balance due will be $10.

4. When the claim has been paid by insurance, the payment and any adjustments will automatically post to your account from Apex. At this point, you delete the estimated payment and the remainder will be the new balance due.

That's it! If you have any questions, please contact us.

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