When you use the “add patient portion” button on the insurance invoice and you apply a copay it creates a positive copay line item on the patient invoice and a negative copay line item on the insurance invoice. If you run an “all sales by type” report both of those show up. The insurance copay is the negative and the one that just says “copay” is really the “patient copay” or the positive amount. These should always offset each other in the sales report.