"FORGIVE" YOUR CO-PAYMENT? By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals with offices in Mequon & Saukville, Wisconsin
At the beginning of every year we start getting calls from patients requesting that we "forgive" their insurance co-payments. Some ask nicely, but others are pretty insistent that we not collect their co-payments for examinations or surgical procedures. This comes up at the beginning of the year because most plans have a specified maximum co-payment per individual or family per year and the amount generally starts over on January 1st. Just to save our billing staff from another call on this subject, let me explain what co-payments are and how they function as part of your health insurance plan.
Co-payments are designed to share some of the costs of medical care with the patient. Often a policy will offer lower monthly premiums in exchange for an increase in the co-payment due at every visit to a doctor. When co-payments go up, that does not mean that the doctor is receiving more for your visit. It just means that the amount paid directly by the insurance company to the doctor has gone down.
You may not realize it but if we 'forgive" a co-payment, it is actually insurance fraud. We have contracts with most major insurance companies that specifically state the fees we will be paid for each type of examination, testing and surgical procedures we provide. These fees are based on the assumption that the patient will cover the co-payment. If we do not collect the co-payment, we are violating these agreements and risk losing our ability to see patients covered by that insurance plan in the future.
Now you know that as much as we would like to "forgive and forget", it is not so simple. Happy New Year!
Dr. Mark German is an Optometrist practicing at Lakeshore Eye Care Professionals with Dr. Martha Jay. He specializes in comprehensive eye care for patients of all ages and accepts most insurance plans.
For more eye care information, call 262-241-1919 or visit www.LakeShoreVision.com