How do I make sure I am compliant in collecting co-pays?

Handling Copays: Prospective vs. Retrospective

Copays should be collected before delivery whenever possible. This helps prevent:

• Medication refusal
• Fraud and waste
• Collection issues

If copays aren’t collected, have a clear, documented process in place:

• Consult with your local attorney about writing off uncollected balances
• Maintain proof of collection attempts
• Never implement a blanket policy to write off copays after X days without legal backing

Pro Tip: Consider Facilities as Secondary Guarantors

If dealing with high-risk populations (e.g., mental health or dual-coverage patients), consider having facilities sign on as secondary financial guarantors for unpaid copays. This ensures patients continue receiving essential meds while protecting your business from avoidable losses.