Auto-charge after insurance

Auto-charge lets Ona charge a patient's saved card for the part insurance leaves behind, instead of waiting for your team to send the invoice. You turn it on once for the organization, then each patient opts in card by card.

How do I turn on auto-charge after insurance pays?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Billing, click Auto-charge.

Use this setting when you want approved post-insurance balances to run automatically, but only up to an amount you set. Denied claims and balances over that amount are never charged automatically.

The screenshot shows the Settings (1) item in the sidebar and Auto-charge (2) in Billing.

If the setting is unavailable and you see Insurance settings, turn on insurance first. See Setting up insurance.

1. Turn on Charge the patient's share automatically.
2. In Notice period, enter how many days to wait between the notice email and the charge. You can use 0 to 30 days.
3. In Most to charge, enter the largest amount Ona should charge automatically on one invoice.
4. If you see Connect Stripe to charge cards, click Connect Stripe and finish your Stripe setup.
5. Click Save changes.

When insurance is on and both Notice period and Most to charge are set, the page also shows When, Up to, and Who in What patients see so you can review what patients will see. If Notice period is 0, the charge runs right away and the receipt is the only email the patient gets.

How do I record a patient's agreement on their saved card?

In a patient's record, open the patient's billing page. On that page, use Charge after insurance pays when the patient has already agreed in person, by phone, or on a signed form. This saves staff-recorded consent for that saved card.

1. Turn on Charge after insurance pays.
2. In Record the patient's agreement?, click Record agreement only if the patient agreed to let the clinic charge that card for their share of a visit once insurance has paid.
3. To remove consent later, turn off Charge after insurance pays.

After consent is saved, the row shows either Agreed in the portal on the date or Recorded by staff on the date. When you record agreement, your name is recorded with it. If insurance is turned off for your organization, this control stays unavailable until insurance is on again. A new card needs a new agreement.

How do patients and guardians turn it on in the portal?

In the patient portal, patients use Payment method to save a card and opt in. Guardians acting for a dependent see the same choice for that dependent's payment method.

1. Open Payment method in the patient portal.
2. If there is no saved card yet, click Add card securely and complete checkout. If there is already a saved card, click Update card to replace it.
3. Turn on Pay my share automatically after insurance.
4. To opt out later, turn off Pay my share automatically after insurance.

The switch appears only when your organization offers auto-charge and the patient already has a card on file. The portal text tells the patient that the clinic may charge the card for their share once insurance has paid, and that they can turn it off at any time. If your notice period is more than 0 days, the portal also says they will be emailed before each charge and get a receipt after. If your notice period is 0, the portal says they will get a receipt for each charge.

For help getting patients into the portal, see Inviting patients with setup links and QR codes. For dependent access, see Guardian and dependent profiles in the patient portal.

What can't I do here?

Auto-charge is limited in these ways:

• Staff and clinicians cannot manage the organization-wide Auto-charge setting in Settings.
• The organization-wide switch and the staff consent control stay unavailable until insurance is turned on.
• Ona charges only patients who agreed on that saved card, either in the portal or through staff-recorded consent.
• Denied claims and balances over Most to charge are not charged automatically.
• If Stripe is not connected or cannot take payments, invoices are flagged Ready to send instead of charging the card automatically.
• A saved agreement does not carry over to a new card. A new card needs a new agreement.

Common questions

What does 0 days in Notice period mean?

It means the charge runs right away after insurance pays, and the receipt is the only email the patient gets.

Is Most to charge per invoice?

Yes. Most to charge is the maximum Ona will charge automatically on one invoice.

How can I tell whether consent came from the portal or was recorded by staff?

The patient's billing row shows either Agreed in the portal on the date or Recorded by staff on the date.

What if the patient replaces their card?

The old agreement does not carry over. The patient needs to agree again on the new card, or your team needs to record a new agreement for that card.