Why do some of the EOB's , when posting payments, have PR-3 (copay) posted to be payed by the patient on all of the entries, when the copay is only supposed to be taken at the beginning of the visit?
Why do some of the EOB's , when posting payments, have PR-3 (copay) posted to be payed by the patient on all of the entries, when the copay is only supposed to be taken at the beginning of the visit?
Thank you for clarifying Susan, so even if I am seeing multiple copays being posted for the same patient on the same day, that is correct?The copay still has to be accounted for on the EOB, regardless of when it is collected.
Additionally, if the EOB does not show that a copay was due and the patient paid one at the visit, then the patient should likely be refunded.
an example would beThe copay still has to be accounted for on the EOB, regardless of when it is collected.
Additionally, if the EOB does not show that a copay was due and the patient paid one at the visit, then the patient should likely be refunded.
an example would be
patient was seen on 3/5/2025 copay was collected for $25.00, on the EOB it say to collect the copay for all 3 codes.
3/5/2025 99213 $0.00 PR-3 CO-45
3/5/2025 20610 $0.00 PR-3 CO- 45
3/5/2025 J1010 $0.00 PR-3 CO-45
My understanding is that the copay is only collected once.
Is there an actual $ amount associated to that "PR-3" for every line, or do they show as $0, like in your example?an example would be
patient was seen on 3/5/2025 copay was collected for $25.00, on the EOB it say to collect the copay for all 3 codes.
3/5/2025 99213 $0.00 PR-3 CO-45
3/5/2025 20610 $0.00 PR-3 CO- 45
3/5/2025 J1010 $0.00 PR-3 CO-45
My understanding is that the copay is only collected once.
Yes, there is an actual dollar amount for each PR-3. That is why I am confused because I thought the Copay was only collected once but from what the claim is saying it looks like they are collecting it multiple times on a single claim. I just started posting payments 2 months ago and so I'm wondering how this all works. and wanna make sure what I am seeing is correct.Is there an actual $ amount associated to that "PR-3" for every line, or do they show as $0, like in your example?
If these 3 services were all billed on one claim, the PR-3 probably shows on each charge line associated to that 1 claim. If they do not have an actual $ amount, then I would assume that the $25 only applies to the one line it shows on.
You can always try looking on the payer's portal.... claims (for me at least) are a bit easier to read/decipher on most portals than on the EOBS*