Patient Ledger Settings

The Patient Ledger allows users to collect payments, add charges, apply credits, and add transactions to a patient’s account. It also displays lists of patient payments, charges, and total amounts due, and contains the Patient Ledger Report, which allows you to review financial statements within specific time frames.

Required Permissions: Only Super Admins can set up the Patient Ledger. 

New to Patient Ledger? Click here for more information on how it works.  

Enable Patient Ledger  

1. To enable Patient Ledger, click on your Initials in the header and select Settings.
    
   
2. Click on the Instance tab.
3. Scroll down to the Show Patient Ledger section.
   
   • Enable Show Patient Ledger if your facility wants to track charges and patient payments directly on the patient chart. 
   • Enable Patient Signature on Ledger if your facility needs to collect patient signatures on transactions. 
4. Click Submit to save your changes.

Accessing Ledger Settings

Super Admins can set up pre-defined expenses for items that are not covered by insurance or other available options for private pay patients. They can also customize this section based on facility protocols.  

1. To set up a patient ledger, click on your Initials and select Settings.  
2. Select Billing > Ledger.
3. You can set up charge accounts, payment types, and statement templates from the Ledger tab.

Charge Accounts 

You can set up standard charges that can be posted manually or automatically to patient accounts based on your facility's needs. Common charges include admission fees, medication rates, clinical services, doctor’s visits, housing, locker fee, transportation, recurring fees, insurance deductible, labs, etc.   

1. From the Charge Accounts tab under Billing Settings, click on the + New Charge Account button.
   
2. Create a name for the charge account and click on Create.
3. Under Default Values, enter the number of units and the unit cost in the corresponding fields. These values will be used when adding the charge to a patient manually. The Enabled checkbox is selected by default.
4. Specify the Location(s) where this charge will be available.  
5. Click on Add Rule + (if desired). A new section will expand where you can set up as many rules as needed. 
6. Type: Select MAT Dosing or Recurrent from the drop-down. 
   • MAT Dosing: Applies the charge when a patient receives a dose via MAT Order (used by MAT Facilities). 
     • MAT Medication: Select the medication from the dropdown list of available MAT Medications  
     • Amount From/To: A charge will be generated for all doses whose amounts are between the quantities entered in the From and To fields. Amount From is required but Amount To is optional. This tool can be used to create different price quotes for different dose amounts.
   • Recurring: Automatically adds the specified charge(s) to the patient’s account every week or month based on the rule. 
     • If Weekly: Select the day of the week on which to generate the charge automatically. 
     • If Monthly: Select the day of the month on which to generate the charge automatically.
7. Description: Free type any desired details about the charge.  
8. Unit Cost: Enter the amount to be charged per unit. 
9. Payor is: Select the appropriate payor option from the drop-down list.
   
   • Private Pay: Any payment method configured as Private Pay in Settings > Patients.  
   • Any: Generates self-pay charges for all patients.  
   • Select Payors: Choose payors from the autocomplete field database. You can select one or more payors. 
10. Enabled: Remember to check this box to enable the rule or uncheck it to disable the rule. Once the rule has been enabled, the grey background will turn blue.  
11. Delete: Click on the trash icon to delete the rule.  
12. Save: Click Save once you are done. 

MAT Facilities: MAT Order schedules work in conjunction with MAT Dose type rules to calculate the payment due prior to a patient receiving doses.  

Payment Types 

Create the different payment types accepted by your facility. Common payment types are cash, check, credit card, and money order. If your organization is integrated with Stripe, click here for instructions on configuring Stripe Payment Methods. 

1. From the Billing Settings tab, open Payment Types and click on the + New Payment Type button.
2. Name the payment type and click Create.
   
3. The Enabled checkbox is selected by default.   
4. You can optionally enable this payment method with Stripe to allow credit card payments to be collected and processed directly from the EMR using the Stripe Credit Card checkbox. Click here to learn more about setting up the Stripe Integration. 
5. Select Location(s) that will use this payment type and click Save. 

Statement Templates  

Statement Templates allow you to build Facility Statements based on your internal protocols. Payment Types are configured in Settings > Billing > Ledger > Payment Types.  

1. From the Billing tab, open Statement Templates and click on the + Add New Location button.
   
2. Select the Location from the drop-down list.
   
3. Click on the Edit icon to start customizing the template.
4. Build the Statement Template to suit your facility needs. The form builder functions just like Consent Forms. Check out the linked article for more information.
5. Once you add the necessary data fields and/or any additional content in the header and footer, click Save.

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.