Co-Payments vs. Patient Payments
PatientStudio distinguishes between co-payments and patient payments, each with unique rules for allocation and processing.
Co-Payments
Definition: Payments allocated to a specific date of service (e.g., commercial insurance co-pay, Medicare co-insurance).
Application:
Processed via the Calendar or Financials tab.
Appears as a credit on the claim.
Can be used for co-pays, co-insurance, self-pay, or prepayment of deductibles.
Only one co-pay can be collected per date of service.
Patient Payments
Definition: Payments applied to a patient’s total balance, distributed across the oldest unpaid claims.
Application:
Processed via the Financials tab.
A payment is applied to the earliest outstanding balance across multiple dates of service.
Overpayments remain as a credit for future claims.
Key Differences from Co-Pays:
Unlike co-pays, payments are not tied to a specific date of service.
Payments are applied to any outstanding balance across multiple claims.
Payment Application Rules
PatientStudio automatically applies payments to claims and open balances.
Co-pays are applied first to any open balance for the specific date of service.
Payments are then applied to the oldest unpaid dates of service until the payment is fully used.
Older payments are applied first before newer payments. Example: the patient has a credit.
This automated process ensures accurate balance tracking while prioritizing the correct payments based on claim status.