> ## Documentation Index
> Fetch the complete documentation index at: https://docs.bizaxl.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Billing and Finance
> How to invoice patients for dental consultations, treatments, X-rays, laboratory items, sedation, and orthodontic treatment plans - and how to track outstanding billing daily.
Every procedure, X-ray, consultation, and lab item must reach an invoice. In a dental clinic, billing is procedure-driven: the fee is tied to what was done, which tooth, and sometimes how many surfaces or units were involved. This page explains how to create invoices for dental services, manage treatment plan payment structures, and monitor outstanding billing at the end of each day.
***
## Before You Start
* Each billing item must be linked to the relevant Appointment Type, Clinical Procedure Template, and Lab Test Template.
* Healthcare Settings must be configured for your billing preferences.
* You need the **Healthcare Administrator** role to create sales invoices.
***
## What Gets Billed at a Dental Clinic
| Service | When It Is Billed |
| ---------------------------------------- | ------------------------------------------------------------------------ |
| Patient Registration Fee | At first registration (if your clinic charges a registration fee) |
| Consultation / Examination Fee | After the Patient Encounter is submitted |
| X-Ray Fee (OPG, IOPA, Bitewing) | After the X-ray procedure is submitted |
| Scaling and Polishing | After the procedure is submitted |
| Filling (per tooth, per surface) | After the procedure is submitted |
| Root Canal Treatment (per appointment) | After each RCT appointment procedure is submitted |
| Crown Preparation Fee | After the crown prep procedure is submitted |
| Crown Fit Fee | After the crown fit procedure is submitted |
| Laboratory Item (crown, bridge, denture) | Usually invoiced at fit, or split: deposit at prep, balance at fit |
| Extraction (simple or surgical) | After the procedure is submitted |
| Wisdom Tooth Removal | After the procedure is submitted |
| IV Sedation Fee | After the procedure is submitted |
| Implant Placement Fee | After the procedure is submitted |
| Implant Crown Fee | After the procedure is submitted |
| Orthodontic Fees | Spread across the treatment period (see Orthodontic Payment Plans below) |
| Post-Operative Review | May be included or separately billed depending on clinic policy |
| Prescription | If separately charged |
***
## The Billing Workflow
```
Procedure performed
(Filling, extraction, X-ray, crown prep, etc.)
│
▼
Clinical Procedure record submitted
│
▼
Service appears as unbilled
(Appointments to Bill count increases)
│
▼
Front desk opens Sales Invoice → New
Links to patient's customer record
Adds all services from this visit
│
▼
Patient pays (cash, card, insurance, payment plan instalment)
Invoice submitted
│
▼
Invoiced field ticks on each Clinical Procedure
Appointments to Bill count decreases
```
***
## Creating an Invoice for a Dental Visit
To invoice a completed consultation:
1. Open the Patient Appointment record
2. Click **Create Invoice**
3. The consultation fee auto-fills from the Appointment Type billing item
4. Manually add any additional procedures performed at the same visit:
* Scroll to the items table
* Add each Clinical Procedure billing item (filling, X-ray, scaling, etc.)
5. Confirm the total
6. Collect payment and submit the invoice
***
## Billing for Multiple Procedures in One Visit
A typical dental visit may involve several procedures billed on one invoice:
| Scenario | Invoice Items |
| ----------------------------------------- | ------------------------------------------------------------------------------------------- |
| New patient examination + OPG + bitewings | Examination fee, OPG fee, bitewing fee |
| Recall + scaling + one filling | Recall exam fee, scaling fee, filling fee (per tooth/surface) |
| Extraction + post-op review | Extraction fee (review included or separate per policy) |
| Crown prep visit | Examination fee (if applicable), crown preparation fee, temporary crown fee, impression fee |
| Crown fit visit | Crown fit/cementation fee, laboratory item cost (crown) |
***
## Billing for Crown and Bridge Laboratory Items
For prosthetic work involving the dental laboratory:
**Option 1: Bill at the fit appointment**
Invoice the crown preparation fee at the prep appointment, and invoice the crown material/lab cost at the fit appointment once the work is confirmed satisfactory.
**Option 2: Split billing**
Collect a deposit at the prep appointment to cover the laboratory cost, and collect the balance at the fit appointment. The deposit is recorded as a partial payment against a pro-forma or advance payment entry.
Document the approach consistently so patients know what to expect at each appointment.
***
## Orthodontic Payment Plans
Orthodontic treatment runs over 12-24 months. Most clinics offer a payment plan rather than asking the patient to pay the full fee upfront.
**Common orthodontic billing structures:**
| Component | When Billed |
| --------------------------------- | ---------------------------------- |
| Assessment fee | At the assessment appointment |
| Records fee (OPG, models, photos) | At the assessment appointment |
| Bond-up fee (deposit) | At the brace placement appointment |
| Monthly adjustment fee | At each adjustment appointment |
| Debond fee | At the brace removal appointment |
| Retainer fee | At the retainer fit appointment |
Alternatively, some clinics bill a comprehensive fee and then split it into equal monthly instalments. In this model, create sales invoices monthly or use the advance payment approach.
Record any payment plan agreement in the patient's appointment notes or a separate financial note attached to their patient record.
***
## Fee Validity (Free Follow-ups)
After a paid consultation, patients may qualify for free follow-up visits within a set period. This is less commonly used in dental than in medical contexts, but may apply to:
* Post-extraction review (if included in the extraction fee)
* Post-crown-fit review (included in the crown package)
* Post-RCT review (if the RCT includes one free review)
Configure in Healthcare Settings:
* Enable Free Follow-ups: ON
* Valid Number of Days: set to your policy (e.g., 30 days)
* Number of Encounters: 1 (for one free follow-up)
When the patient returns within the valid window, the consultation fee is not charged.
***
## Insurance and Corporate Billing
For patients with dental insurance or corporate dental benefit schemes:
1. Record the insurance details in the Patient record or appointment notes
2. After the procedure is completed, raise the sales invoice as normal
3. Instead of collecting payment from the patient, mark the payment method as "Insurance" or "Corporate"
4. Submit the insurance claim separately using your insurer's process
5. When the insurer pays, record the payment receipt against the invoice
Keep a note in the patient record of the insurance company, policy number, and any pre-authorisation references.
***
## Healthcare Settings: Billing Configuration for Dental
| Setting | Recommended Value |
| ----------------------------------------- | ------------------------------------------------------------------------------ |
| Collect Registration Fee | Yes (if your clinic charges a joining fee) |
| Show Payment Popup | Yes - front desk collects payment at time of visit |
| Enable Free Follow-ups | Yes (for post-operative reviews included in the procedure fee) |
| Valid Number of Days | 30 days |
| Allow Discharge Despite Unbilled Services | No - billing should be cleared before sedation patients are discharged |
| Process Service Request Only If Paid | Optional - relevant if your clinic collects X-ray fees before taking the X-ray |
| Out Patient Consulting Charge Item | Link to your dental consultation billing item |
| Clinical Procedure Consumable Item | Link to a general dental consumables billing item |
| Income Account | Link to your dental services income account |
| Receivable Account | Link to your accounts receivable account |
***
## Monitoring Billing Daily
### Daily Check
At the end of each clinic day:
1. Check **Appointments to Bill** number card - target is zero
2. Open the Clinical Procedure list and filter by **Invoiced = No** - any procedures not yet invoiced should be invoiced before the day ends
3. Check that all submitted patient encounters have a corresponding sales invoice
### Weekly Check
1. Run **Patient Appointment Analytics** to compare appointment count with invoice count - a mismatch means something was not invoiced
2. Review outstanding invoices (unpaid) - follow up on patient balances
***
## Troubleshooting
**A procedure is not appearing in the billing items when creating the invoice**
The Clinical Procedure Template may not have a billing item linked. Open the template, add the billing item, then re-link the template to the procedure record before re-invoicing.
**The patient was charged the wrong amount for a filling**
The billing item rate may be set incorrectly on the Clinical Procedure Template. Check the template rate and update it if needed. Create a credit note for the overcharged or undercharged amount and raise a corrected invoice.
**The orthodontic patient has missed a monthly payment**
Follow up with the patient using the outstanding invoice report. The payment plan terms should have been agreed in writing at the start of treatment. Document all follow-up attempts in the patient's notes.
**A crown does not fit and needs to be remade - how to handle billing**
If the crown is being remade due to a laboratory error, the lab should bear the cost of remaking it. Do not charge the patient again for the crown material. The fit appointment for the remade crown may or may not be charged depending on your clinic's policy - be consistent and communicate clearly with the patient before the appointment.
***
## Best Practices
* Invoice on the day of the visit - dental patients visit across multiple appointments and waiting until the end of treatment to invoice creates confusion and makes it harder to collect payment
* For multi-visit treatments (root canal spread across two appointments), invoice each appointment separately on the day rather than waiting for the treatment to be fully complete
* Print an itemised receipt for every patient - clear itemisation reduces billing disputes and builds patient trust in the clinic's pricing
* For any procedure where the fee is higher than usual (complex extraction, lengthy crown preparation), discuss the fee with the patient before starting and record that the fee was agreed
* Keep the fee schedule up to date: when you change your prices, update the rates on the Clinical Procedure Templates and Appointment Types immediately so invoices generate the correct amount from day one
***
## Related Features
* [Appointments](/health-wellness/dental-clinic/appointments): Appointments are the primary consultation billing trigger
* [Dental Treatments](/health-wellness/dental-clinic/dental-treatments): Procedures are the most frequent billing source
* [Laboratory](/health-wellness/dental-clinic/laboratory): Lab items (crowns, dentures, blood tests) are billed here
* [Oral Surgery](/health-wellness/dental-clinic/oral-surgery): Surgical and sedation fees
* [Orthodontics](/health-wellness/dental-clinic/orthodontics): Orthodontic payment plan management
* [Clinic Settings](/health-wellness/dental-clinic/clinic-settings): Billing rules configured in Healthcare Settings