Patient Ledger

The Patient Ledger allows users to process payments, create charges, apply credits, generate statements, and collect signatures directly from the Patient Chart. You can also view the total amount due or credits in the patient’s account.  

Additionally, if your organization is using Queues, you will receive a notification when checking in the patient if they have an amount due.

Required Permissions: Super Admin, Records Admin, or Manage Ledger roles.

New to Patient Ledger? Click here to learn how to set up Patient Ledger for your organization.

Access Patient Ledger

The Patient Ledger is available in the patient chart under the Billing tab. Note: The name of this tab is customizable, so it may be named Patient Ledger or something else entirely, depending on your facility’s preferences.

From this tab, you can complete multiple actions:

1. Click on the Payment Screen Actions to process payments, create charges, apply credit, generate statements, and collect signatures in the patient account.
2. Find the Amount Due or Credit Amount on the right-hand side of the screen.
3. Use the Filter box to find any charges and payment information.
4. Use the Sort icon to organize the data on descending or ascending.

Add Charges

You can manually add a charge or multiple charges to the patient’s account here. Note: Charges can also be automatically added to the patient chart based on the Charge Account settings.

1. Click on the Charge button to begin.  
    
2. Fill out the required items indicated with an asterisk (*) in the pop-up window: 
   1. Date: Enter the Date and Time in the Charge Transaction window.
   2. Account: Enter the account to be charged. The system displays the options previously configured by the Super Admin. Click here to review Patient Ledger set up. 
      • Please Note: The drop-down menu options are unique for each facility based on the facility protocols. The most common charges include admission fees, medications rates, clinical services, doctors’ visits, housing, locker fees, transportation, recurring fees, insurance deductible, labs, miscellaneous, etc.
   3. Description: If desired, you can add a description of the charge.
   4. Units: Units should correlate to the total number of units the patient will receive. If you increase the number of units, the system will automatically increase the unit cost and total charge.
   5. Unit Cost: This will display how much each individual unit costs.
   6. Total Charge: This shows the total amount calculated by the system (this amount should equal the number of units times the unit cost).
   7. Notes: Enter any additional notes, as needed.
   8. Click on the Submit button once you have reviewed the transaction.
3. Clicking on the plus icon provides details about the transaction.
    
4. After clicking on the plus icon, the system provides detailed information about the transaction. The system allows you to add attachments if needed.

Update Charges

Once you have entered a charge, the system allows you to edit, adjust, and void the charge transaction (if needed) by clicking on the Edit icon.

Edit a Charge

If you select the Edit radio button, you can make changes to the Description and Notes fields. Click Submit after you amend the desired fields.

Adjust a Charge

If you click on the Adjust radio button, you can make changes to the Units, Unit Cost, Total Charge, and the Amount to Apply fields. Click Submit after adjusting.

Void a Charge

After selecting the Void radio button, the system will not allow you to make changes to any field. Click Submit after to void the transaction.

When a charge is voided, it will appear in the transactions list entirely struck through.

Collect Payments

The Payment button is used to record diverse payment types. Payment Types are configured by Super Admins under Settings > Billing Audit Tool > Ledger. Most facilities record cash, credit cards, checks, and money order payments.  

1. Click on the Payment button to begin.
2. Fill out the Payment Transaction pop-up window items. Required fields are indicated by an asterisk (*). 
   1. Date: Select the desired date and time of the payment. 
   2. Account: Choose the desired account. Payment will be selected by default. 
   3. Description: Add a description if desired.  
   4. Payment: Enter the payment amount. 
      • Note: Pay special attention to the numbers here. When you click on the field, it will only enter dollar values. If you need to add cent values, you will need to specifically click on or use the arrow keys to move to the cents side.  
   5. Payment Type: Select the desired payment type from the drop-down. These options must be set up by Super Admins (for more information on setting up payment types, check out this article. (Click here to review the Patient Ledger setup). The most common payment types are cash, credit card, check, and money order. 
   6. Notes: Add notes, as desired.  
   7. Apply Payment To checkbox: At the bottom of the screen, you will find all the patient’s charges. Select or deselect the charge accounts you would like to apply payment to using the checkboxes. 
   8. Click Submit.   

Stripe Integration

If your facility has integrated with Stripe to process patient credit card payments, you'll have an additional option on the Payments screen that allows you to manually enter card details or swipe the card using an integrated reader. Click here to learn more. 

Update Payments

Once you have entered a payment, the system allows you to edit or adjust it by clicking on the Edit icon.

Edit Payment

Select the Edit radio button to make changes to the Description and Notes fields. Click Submit after you amend this content.

Adjust Payment

If you select the Adjust radio button, you can make changes to the Payment Amount and the Amount to Apply fields. Click Submit after adjusting.

Apply Credits

Credits are payments that have not yet been assigned to a charge. When the patient has been charged and a payment has been submitted, the system will automatically deduct the charge from the credit. 

1. To apply an outstanding credit balance to a charge, click the Apply Credit button.
2. Select or deselect the checkboxes to apply or remove credit as needed. If the box next to a transaction is checked, the existing credit will be used to pay it. Once you have selected all the payments you wish to apply a credit to, click Submit.
   
3. To review the transaction, locate the charge the credit was applied to and click on the + icon.
4. You can now view the transaction details. The system also allows you to add attachments if needed.
5. If you need to reverse a recent transaction, click on the Reverse icon.
   
6. The system will display a message asking you to confirm that you want to reverse the payment. Click OK to proceed. 
   
7. Reversed/Voided items remain listed with the other transactions but are struck through.

Generate Statements

You can create a statement to provide to the patient based on a specified date range.    

1. Begin by clicking the Generate Statement button.
2. In the Generate Statement pop-up, click on the Start Date and End Date fields to choose the date range for the statement and click Go. 
   • Note: If you do not select an end date, a calendar month will be chosen by default.  
3. Once a date range is selected, the system will generate a PDF statement that can be downloaded and/or printed as needed.  
   
4. Balance Forward: This is the patient's balance as of the start date of this statement. 

Collect Patient Signature 

1. To collect a patient signature, click on the Patient Signature button.
2. In the next window, select the transactions the patient needs to sign, and have the patient sign their name in the box. Then click Submit.
3. The signature and time stamp will appear on the ledger. 

Patient Ledger Report

The Patient Ledger Report lists all charges, payments, and adjustments posted for patients, allowing facilities to review outstanding balances from specific timeframes and export them as needed.  Click here to learn more about the report.