Auto-Billing for Copays, Deductibles, and Coinsurance
Automatically charge or invoice a client for their copay, deductible, or coinsurance amount after an insurance-billed appointment, calculated using contracted rates set per CPT code and payer. If a card is on file, the charge is scheduled two days after the appointment; if not, an invoice is generated and emailed immediately. Requires enabling insurance billing at the appointment-type level and setting per-payer contracted rates.
Built by Core Engineering
The problem it solves
Collecting a client's copay, deductible, or coinsurance after insurance has been billed usually requires manually calculating the amount and following up separately, which is easy to fall behind on across an insurance-based caseload. This automation solves that by calculating the patient responsibility automatically from contracted rates and charging or invoicing it right after the appointment.
What's included
- Auto-Charge setting, scheduling a card charge 2 days after the appointment
- Auto-Invoice setting, generating and emailing an invoice immediately if no card is on file
- Contracted rate configuration per CPT code and payer for accurate coinsurance calculation
- Appointment-type-level insurance billing designation to control which types trigger the automation
- Email notification to the client when a charge or invoice is generated
How it works
An admin enables Auto-Charge and/or Auto-Invoice from Insurance Settings, then marks which appointment types are insurance-billed under Settings > Services so Healthie knows which sessions to apply the automation to. Under Insurance-Specific Pricing, the admin sets a contracted rate per CPT code for each payer; for example, a $100 contracted rate with 10% coinsurance calculates a $10 client responsibility. When a qualifying appointment occurs, if Auto-Charge is enabled and a card is on file, a charge is scheduled for two days later; if Auto-Invoice is enabled and no card is on file, an invoice is generated and emailed to the client immediately. Clients receive an email notification when either action occurs, and both the resulting charges and invoices are visible under Billing > Payments or Billing > Invoices; deleting a generated invoice does not cancel its associated scheduled charge.
Auto-Billing for Copays, Deductibles, and Coinsurance automatically charges or invoices a client for their out-of-pocket patient responsibility after an insurance-billed appointment, using contracted rates configured per CPT code and payer. It's built for insurance-based practices that want to collect the client's portion of a bill without manually calculating coinsurance or chasing down payment after every session. Providers enable Auto-Charge, Auto-Invoice, or both from Insurance Settings, and set contracted rates under Insurance-Specific Pricing for each payer and CPT code combination so coinsurance percentages can be calculated correctly. Some payer or benefit details may still need to be confirmed by phone if they weren't captured during intake.