Invoicing patients and collecting payments

Invoices bill the patient directly. Use them for self-pay visits, copays, retail or inventory items, package balances, or patient responsibility after insurance. Claims are separate: claims bill the payer, while invoices bill the patient.

Owners, admins, and staff use the organization-wide Invoices page. Clinicians review invoices from the patient chart or a visit. When you open an invoice, you can review its stage, balance, line items, totals, notes, adjustments, payments, and related claims, then use PDF and the actions available for that invoice. The page opens in List or Board view, and both views use the same invoice actions.

How do I review invoices?

In the left sidebar, under Admin, click Invoices to work from the organization-wide invoice page in List or Board view.

Use Invoices (1) to open the organization-wide page, List / Board (2) to switch views, Updated (3) to choose how far back the list looks for invoice changes, and Status (4) to narrow the list further.

1. In the left sidebar, under Admin, click Invoices.
2. Use the List and Board toggle to switch between the grouped list and the board view.
3. Use Search invoices to find invoices by invoice number or patient name.
4. Use Updated to choose the last-updated window for the list.
5. Use Status, Patient, Billing profile, or Created to narrow the list.
6. Click the invoice row or card you want to open.
7. If the list says no invoices were updated in the current window, click Show all time.

Invoices are grouped by stage. The list can show Draft, Ready to send, Sent, Overdue, Partially paid, Paid, and Void groups, and Paid and Void start collapsed by default. A row can show a billing profile label when the clinic has multiple profiles. Ready-to-send invoices can show a Ready to send badge, and scheduled auto-charge invoices can show an Auto-charge badge. For visit-penalty invoices, the row can show the fee label for late cancellation, no-show, or reschedule instead of a generic line count. From a row's ⋯ menu, you can use Open patient chart, Copy invoice number, Send to patient when it is ready to send, and the actions available for that row. Open patient chart opens the chart in a new tab.

How do I review a patient's invoices from the chart?

In the left sidebar, click Patients, click the patient's name, then in the patient sidebar, under Billing, click Invoices to see that patient's invoices only.

Use Patients (1) to open the chart. In the patient sidebar, use Invoices (2) under Billing to open that patient's invoice list.

1. In the left sidebar, click Patients.
2. Click the patient's name.
3. In the patient sidebar, under Billing, click Invoices.
4. Click the invoice row you want to open.

The list is already limited to that patient.

How do I open an invoice from a visit?

In the left sidebar, click Patients, click the patient's name, then in the patient chart click Visits and open the visit you want.

Use Visits (1) to open the patient's visit list. On the visit page, use the Billing area (2) to open the invoice or create a draft from that visit.

1. In the patient chart, click Visits.
2. Open the visit you want.
3. In the visit's Billing area, click View invoice if the visit already has an invoice.
4. If there is no invoice yet and you are an owner or admin, click Create draft invoice.

The invoice opens in its detail sheet. If you create a draft from the visit, it opens there so you can finish it. For visit-penalty invoices, the detail sheet can show the fee label under the patient name, and staff can see View visit when they have access to the consultation.

How do I create a draft invoice?

In the left sidebar, under Admin, click Invoices on the organization-wide page to start an invoice before you send it or collect payment.

1. In the left sidebar, under Admin, click Invoices.
2. Click New Invoice.
3. Choose the patient in Patient.
4. Add the billable items that should appear on the invoice.
5. Click Create draft invoice.

The invoice is created in Draft. Drafts are the only invoices you can edit in place.

How do I add or edit invoice line items?

In the left sidebar, under Admin, click Invoices, or open a patient's Invoices list in the chart, then open a draft invoice to change what the patient is being billed for.

Select the Line item (1) row to edit it. Update Qty (2) and Unit price (3), then click Save (4) to keep the change.

1. Open the draft invoice.
2. Click a line item to edit it, or click Add line item to add a manual line.
3. Update Description, Qty, and Unit price.
4. Click Save for an edited line, or Add item for a new line.
5. To remove a manual line, open it again and click Remove when that action is available.
6. If inventory billing is enabled, click Add from inventory instead. If your organization tracks locations, choose From before you save.

Line amounts are calculated from quantity and unit price. Quantity must be a whole number from 1 to 9999, and descriptions can be up to 200 characters. Self-pay lines can also show a member discount row and an included amount row when a membership or package reduces what the patient owes. When a self-pay line is fully covered, its status can change to Included.

Some lines are protected because they come from another billing source. Claim lines keep the amount from the insurance claim, and package lines keep the amount from the service package. You can change their description, but not their price, and you cannot remove them. If a draft only has one line left from a visit, that line cannot be removed; delete the draft instead if you need to un-bill that visit.

Inventory lines show on-hand stock, and stock is deducted when the invoice is saved.

How do I send or finalize an invoice?

In the left sidebar, under Admin, click Invoices, or open a patient's Invoices list in the chart, then open a draft invoice when it is ready to issue.

Use Billed to (1) for the patient details, From (2) for the practice details, Due (3) for the due date, Send to patient (4) to email it, and More options (5) for the other issue actions.

1. Open the draft invoice.
2. Review Billed to and From to make sure the right patient and practice details will appear on the invoice.
3. Review Due. On drafts, you can set or change the due date there.
4. Check the line items and totals, including any member discount and included amount rows.
5. Click Send to patient to email the invoice with a pay link.
6. To issue it without email, open the ⋯ menu and click Finalize without sending.
7. After the invoice has been issued, click Resend if the patient needs the email again.

After an invoice is sent or finalized, it leaves draft editing. If you finalize without sending, no email is sent. You can use PDF at any time to download the invoice. If the detail sheet shows Not sent to the patient yet, use Send to patient there to email it.

How do I collect or record a payment?

In the left sidebar, under Admin, click Invoices, or open a patient's Invoices list in the chart, then open the invoice and use the payment actions available for its balance and status.

Use Record onsite payment (1) for cash, check, or the clinic's card terminal, and Charge card on file (2) to charge a saved card.

1. Open the invoice and confirm Balance due.
2. To record cash, check, or your card terminal, open the ⋯ menu and click Record onsite payment.
3. To charge a saved card, open the ⋯ menu and click Charge card on file.
4. To copy a shareable online payment link, open the ⋯ menu and click Copy pay link.
5. If the patient needs the invoice email again, click Resend.

The invoice balance updates as payments are recorded. A payment can leave the invoice partially paid, and a zero balance settles the invoice. The balance and total already reflect any member discount rows and included amounts on the invoice.

If the invoice shows a refundable credit, the invoice can show a refund banner. Use Refund beside a payment or Refund payment in the ⋯ menu when those actions are available. If the banner also offers Keep on account, you can leave the credit for the patient's next invoice instead of refunding it.

If the invoice has a scheduled auto-charge, the detail sheet can show a blue banner such as Card charge scheduled or Card will be charged followed by the charge date. When that appears, use Don't charge to stop the scheduled charge.

How do I add or remove an adjustment?

In the left sidebar, under Admin, click Invoices, or open a patient's Invoices list in the chart, then open the invoice when you need to reduce what the patient owes without editing the line items.

Use Add adjustment (1) to open the dialog, then fill Amount (2), Reason (3), and Note (4) if you need to explain the adjustment.

1. Open the invoice.
2. In Adjustments, click Add adjustment.
3. Enter Amount.
4. Choose a Reason.
5. Add Note if you need to explain the adjustment.
6. Click Add adjustment.

The adjustment comes off the patient's balance and appears in the invoice's Adjustments list after the line-level discounts and included amounts are already counted.

To remove an adjustment, click Remove on that adjustment, then click Remove again in the confirmation dialog. The removed amount goes back onto the patient's balance.

How do I delete a draft or void an invoice?

In the left sidebar, under Admin, click Invoices, or open a patient's Invoices list in the chart, then use the invoice actions when you need to remove a draft or mark an issued invoice void.

Use Cancel (1) to close the dialog without voiding, and Void invoice (2) to confirm the change.

1. Open the invoice, or find it in the list.
2. Open the ⋯ menu.
3. Click Delete draft for a draft invoice, or click Void invoice for an issued invoice.
4. Confirm the action in the dialog.

Deleting a draft permanently removes it. Voiding keeps the invoice in the record, but it no longer bills the patient. On invoices with payments, the row or detail actions can also show Refund payment before Void invoice. If the detail sheet shows a refund banner, it can also offer Keep on account.

How do insurance lines affect an invoice?

In the left sidebar, under Admin, click Invoices, or open a patient's Invoices list in the chart, then open the invoice to read claim and insurance line labels. These labels tell you whether the patient responsibility is final or still waiting on the payer.

Use Billed to (1) for the patient details, From (2) for the practice details, Due (3) for the due date, and Line items (4) for the billed services and insurance labels.

Line label	What it means
Self-pay	The patient owes the line amount.
Awaiting insurance	The payer has not responded yet, so the patient amount is unknown.
Estimated copay · awaiting insurance	A copay amount is expected now, but the final payer decision is still pending.
Covered by insurance	The payer decision leaves the patient owing nothing for that line.
Patient responsibility	The payer decision leaves a patient amount due.

If insurance later leaves the patient owing less than was collected, the invoice can show a refund due. The details panel explains the credit amount and offers a refund action when available. A line can also show Included when a package or membership fully covers it.

What can't I do here?

Invoice actions are limited in these ways.

• Clinicians cannot use the organization-wide Invoices page. They review invoices from the patient chart or a visit.
• Draft invoices are the editable state. Once a draft is sent or finalized without sending, the invoice does not offer the same line-item editing.
• Claim lines cannot be removed from the invoice.
• Package lines cannot be removed from the invoice.
• Claim and package line prices are locked to their source.
• Past dates are not available when setting an invoice due date.
• You cannot void an invoice that still holds payments. Refund it first.
• Paid and void invoices do not allow adjustments.
• On archived patient charts or visits, invoice actions are read-only.
• A voided invoice no longer bills the patient.
• Ready-to-send invoices can surface a Send to patient action from the row menu and the detail sheet banner.
• Scheduled auto-charge invoices can show a blue banner and a Don't charge action.
• If an invoice has no saved card on file, charging it opens a No card on file dialog. From there, you can add a card, and when the action is available, record an onsite payment instead.
• Visit-penalty labels now cover late-cancellation, no-show, and reschedule fees.
• If the clinic has multiple billing profiles, a staff member may need to choose which billing profile an invoice or payment uses.
• When you draft from a visit or create a new draft in a multi-profile clinic, staff may need to choose a billing profile first.
• If payments already taken belong to another billing profile, the invoice can show a warning when you move it.

Common questions

What is the difference between an invoice and a claim?

An invoice bills the patient. A claim bills the payer. A visit can lead to both: a claim for covered services and an invoice for the patient portion. For the claim workflow, see From visit billing to superbill and claim.

Can clinicians see patient invoices?

Yes. Clinicians review invoices from the patient chart or from a visit's invoice card. They do not use the organization-wide Invoices page.

Can I collect a copay before insurance responds?

Yes. An invoice line can show Estimated copay · awaiting insurance. That means the patient amount is being collected while the payer decision is still pending. See Collecting copays.

What does refund due mean?

It means more was collected than the patient now owes. This often happens after insurance adjudication changes the patient responsibility. The invoice stays in the record, but money is owed back to the patient. A line can also read Included when a package or membership covers it, and the invoice total can reflect member discounts and included amounts before any refund is due.

Why can't I void an invoice?

If the invoice still holds payments, you need to refund them first. After the payments are refunded, you can void the invoice if it should no longer bill the patient.

What happens when there is no card on file?

Charging opens a No card on file dialog. You can choose Add card, and if your workflow allows it, Record onsite payment.

Where do I refund a payment?

Open the invoice and use Refund payment from the ⋯ menu when that action appears, or use Refund beside the payment in the detail sheet.

What does Void invoice do?

Void invoice marks the invoice void so it no longer bills the patient. If the invoice still holds payments, refund them first.

What if my clinic has more than one billing profile?

The Invoices page can filter by billing profile, and invoice rows can show which billing profile they use. When you draft from a visit or create a new draft, you may need to choose a billing profile first.

Can I search by patient name or invoice number?

Yes. Use Search invoices in the Filters sidebar to find invoices by invoice number or patient name.