You shouldn't wave copays at the doctors. This is considered a professional courtesy. If you tell a patient they don't have to pay a copay that the insurance company contracted with you for them to pay, then most insurance companies will consider this as fraud. They will view this as a kick back or an intice on your behalf to get patients to come to your practice. The only way a copay should be written off is if faith efforts were considered by the patient to pay the copay(after bills have gone out to the patient)and they have written a financial hardship letter with proof explaining that they can not afford the bill.