Copay
A fixed amount the patient pays for a service, set by their plan.
Get a Free Billing AuditDefinition
A copay (copayment) is a fixed dollar amount a patient pays for a covered service, such as an office visit, set by their plan. Unlike coinsurance, it does not change with the cost of the service.
Copays are usually due at the time of service and are defined by the plan and visit type, which is why they can be collected at check-in once coverage is verified.
Why it matters for billing
Copays are the easiest patient dollars to collect — if they are collected at the point of service. Verifying the copay during eligibility and collecting it up front avoids the cost and delay of statements for small balances.
Related terms
Terms that come up alongside Copay in the revenue cycle.
Billing that gets Copay right
EnVisionMD RCM handles eligibility, coding, documentation, denials and follow-up end to end — so the details behind terms like this one are managed for you, not left to chance.
Request a free billing reviewCopay — frequently asked questions
No. A copay is a fixed amount; coinsurance is a percentage of the allowed amount that varies with the cost of the service.
Usually at the time of service, once the plan and copay amount are verified during eligibility.