Billing and payments

A charge belongs to an encounter and describes the service and amount. The Clinical Coordinator can prepare and review that charge before it is marked approved and invoiced. A voided charge remains distinguishable from an invoice. This keeps a billing question connected to the visit that generated it.

Payments belong to patients, with a received date, amount, reference and status. The coordinator can see whether a receipt is pending, confirmed or refunded. The clinic should define how its accounting or payment system matches patient receipts to invoices using the recorded payment reference.

• Service evidence. The charge refers to the encounter, while its description and amount explain what is billed.
• Charge review. Draft charges provide a place for the coordinator to check care context before approval and invoicing.
• Receipt status. Patient payments carry their own received date and reference for matching with an external payment source.

Define standard service descriptions and how staff determine amounts. Decide who can create a draft, who reviews it and when it becomes approved. Agree when an approved charge is marked invoiced and which system issues the actual invoice. Set a policy for voiding a charge when the service or amount is wrong. Separate that correction from a refund of money already received.

For payments, agree the reference format from the processor or bank and when the clinic considers a payment confirmed. Decide who may record a refund and what independent payment evidence they check. Reconcile patient receipts to the financial system during the first operating cycle.

A patient completes an examination. The coordinator prepares a charge using the encounter and an agreed service description. In Charges for review, the coordinator checks the amount and confirms that the visit record supports the charge. The charge is then approved and can move to invoiced when the clinic issues the invoice through its chosen process.

The patient pays later. Admin records the receipt under the patient, including received date and processor reference, and changes it from pending to confirmed when the payment source confirms it. The coordinator can inspect the receipt. If money is returned, the payment status becomes refunded. The clinic uses the reference to reconcile that receipt with its payment source.

• Charges for review — Draft encounter charges waiting for the coordinator’s decision.
• Patient receipts — Pending, confirmed and refunded patient payment records.

See billing review and the patient visit process.