Because my wife and I both are covered under insurance, but with different insurance companies, I find a problem with recording this.
For example: The pharmacy bills the primary insurance company for a prescription, but requires an up-front copay. I, then, submit the copay to the secondary insurance company.
When I record the transaction in QMEM, I included the copay amount. This zeroed out the transaction. What do I do about the amount that I submitted to the insurance company? Although the transaction could be marked "paid," that's not entirely true. However, if, once I receive the payment from the secondary insurance, I include that in the details, I will have an overpayment showing--even though there isn't one.
Re: Prescription Drug Payments vis-a-vis Copays Nov 02, 2005 11:05 am
Dank, I don't know if this will help you, but here is what I have done in a similar situation where I have two insurance companies:
1. Enter claim normally, including the copay amount. Enter the primary insurance coverage (how handled).
EG. bill for $60, insurance covered $25, write-off $15 and the remaining is $20 (the copay amount).
2. Enter the secondary insurance company (they have paid you zero so far). Set the pending to Pending: Insurance.
3. When you get reimbursed $20 from second insurance...
Enter that the second insurance paid $20. The calculated "Your Responsibility" is now zero. In the additional payment field, enter -20 and press enter. The program will take this and show (20.00) in red... this is a negative. The calculated "My Payments" is now zero and "My Balance" is zero. Set status to "Paid".
The issue that I ran into with this situation is when I also had FSA reimbursements. My FSA is handled automatically by my primary insurance, so my reimbursement would happen before the second insurance was paid. So, now the FSA calculations don't work right. But I decided I could deal with that. Hopefully the next version (or two) of QMEM will allow the entry of the actual FSA reimbursement amount (rather than the program calculating it as the "My Balance" which is zero in this case).
Re: Prescription Drug Payments vis-a-vis Copays Nov 03, 2005 08:46 am
Hi Dank, here I am! :-)
The next version will do a better job of accounting for and helping you resolve overpayments -- that situation where you have to pay a bill that is later reimbursed by insurance. You can read more about the features <url=http://www.quickenforums.com/thread.jspa?threadID=600002284>here.</url>
It should make this process somewhat less complicated, though you'll still need to enter the payments from the two insurance plans.
BeeJul83, thanks for pitching in with a great answer!
