[quote=no_such_reality]I’ve found copays highly varied depending on the doctor practice and your insurance. Kaiser is very strict. With HMOs, the Doctors also tend to be more strict. With PPOs, the Doctors offices are a little more careless with collecting or billing.
Other specialty practices will vary depending on the organization level of the office. The larger the practice the more likely to collect.
Finally, the larger the copay, the more likely the office is to collect.
Mid-year the company I work for switched their prescription coverage to a new provider. Tier 1 copay $10, Tier 2 copay $20, Tier 3 copay 50%. Basically any brand name falls into Tier 3 now.[/quote]
the priority of the PPO provider is not the copay from the patient. the priority is maximizing the billing of the insurance company. the patient is just a tool for the PPO provider to use to justify maximum billing. therefore, giving breaks to the patient (including allowing the co-pay to slide) so the patient can stay with the PPO provider and keep coming back, is reasonable.
the HMO/Kaiser provider can’t maximize billing with procedures and tests. Nor is that the primary focus of the biller. So copay enforcement is stricter.
put it to you this way, PPO provider would want the patient to come back everyday if possible. HMO provider would want the patient to never show up.
