How to Set Up Copay Collection Before Appointments (Step-by-Step)

Collecting copays at check-in slows everything down: forgotten wallets, declined cards, "can I pay later?" When patients pay online before they arrive, check-in moves faster, more gets collected, and nobody chases $25. Here's how to set it up.

Why Collect Copays Before Appointments

1. Faster check-in. Patients who already paid skip the payment step.
2. Higher collection rate. Once a patient leaves the office, the copay gets much harder to collect.
3. Less friction. Your team stops being the one asking for money.

Step 1: Turn On Online Payments

You need online payments connected to your appointments. If patients must log into a separate portal and navigate three screens, they won't pay. The payment belongs in the confirmation: book, see "Pay your copay," enter the card, done.

In Formisoft, patients pay the copay as part of pre-visit intake, with no separate portal.

Step 2: Set Your Copay Collection Policy

Decide the policy first:

• Do you collect copays for all appointment types, or just certain visits?
• How do you handle patients who can't pay online?
• What happens if someone's insurance changes between booking and the visit?
• Do you collect estimated patient responsibility, or just verified copays?

The cleanest approach: collect known copays before the visit and handle exceptions at the desk. The goal is moving most copays out of check-in, not perfect compliance. Put it in a one-page policy so staff know what to say when patients ask.

Step 3: Add Copay Collection to Your Confirmation Workflow

A separate "please pay your copay" email days later gets ignored. Put it in the confirmation, which should include:

• Appointment date, time, and provider
• Pre-visit intake forms (if you use them)
• Copay amount and a payment link
• Instructions on what to bring

Formisoft's pre-visit intake workflow works this way: the forms on the visit go out when the patient books, and intake and copay happen in one session.

Step 4: Send a Reminder 24-48 Hours Before

Some patients won't pay right away. Send one short reminder 24 to 48 hours before:

"Hi [Name], you have an appointment with Dr. [Provider] tomorrow at [Time]. Your copay of $[Amount] is due before your visit. Pay now: [link]. See you tomorrow!"

No apology, no explanation. State it and include the link.

Step 5: Train Your Front Desk Team

Staff need scripts for the exceptions:

Patient hasn't paid online: "I see your copay wasn't processed yet. No problem, you can pay now with a card, or we can send you a link to pay online after your visit."

Patient says they don't have a copay: "Let me double-check your insurance. [verify] It looks like your plan does have a $[X] copay for this visit type. Would you like to pay that now or receive a link to pay online?"

Patient's card declined online: "Your online payment didn't go through. Do you have another card you'd like to use, or would you prefer to pay in person today?"

Stay matter-of-fact: it's a standard payment, not a favor.

We cover more of these scenarios in our guide on reducing patient payment collection time.

Step 6: Monitor Your Collection Rate

Track weekly:

• What percentage of patients pay before arriving
• What percentage pay at check-in
• What percentage leave without paying

If few patients pay before arriving, they're probably not seeing the request, it's too complicated, or the link is buried in a long email. Usually it's clarity.

What About Patients Who Can't Pay Online

Some patients have no card, no email, or struggle online. Keep other ways to pay:

• Let patients call to pay over the phone
• Allow cash or check payments at check-in
• Send paper invoices for patients who request them

If most patients pay online and the rest pay at the desk, you've still removed most of the bottleneck.

Common Mistakes to Avoid

Asking too early: for appointments months out, send the request 5 to 7 days before. Insurance changes and appointments move, and early payments become refunds.

Making it optional: "If you'd like to pay early..." is a suggestion. Say "Your copay is due before your appointment. Pay here: [link]."

No refund policy: decide whether a prepaid copay from a no-show applies to the next visit or is refunded within 5 business days, and say so.

Skipping verification: if coverage changed, the copay may have too. Verify before requesting, or collect an estimate and adjust at check-in.

The Workflow

For a busy primary care practice:

1. Patient books online, or the scheduler confirms by phone
2. The confirmation includes intake forms and the copay link
3. A reminder 48 hours before shows any outstanding copay
4. The front desk handles exceptions at check-in
5. Staff review the collection rate weekly

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Ready to implement this at your practice? See how Formisoft gets every patient ready before the visit, with forms done, reminders sent, and a dashboard that shows who is ready today and tomorrow.