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Clients are typically responsible for their co-payment portion of the bill, but they may also be liable for additional costs depending on their insurance plan and the services rendered. This can include deductibles, coinsurance, and any charges for services not covered by insurance. It's important for clients to review their policy and understand their financial responsibilities fully. Always check with the provider’s billing department for specific details related to individual cases.

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1mo ago

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Why might repeatedly forgiving copayments constitute fraud on the insurance company?

I had to answer this too and it was difficult. I believe the answer is: Because the doctor is in effect misstating the true fee, resulting in overpayment (if a bill is $100 and the copayment is $20, then the insurance company will pay $80. BUT if they excuse your copayment which you are SUPPOSED to pay, they then bill the insurance company $100 instead of only $80. that means they are misstating the true amount that is due and the insurance company is overpaying) i hope that helps!!


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