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Every service at your eye care center needs to reach an invoice: eye examinations, OCT scans, visual field tests, fundus photography, cataract surgery, LASIK, intravitreal injections, and all post-operative follow-ups. If something is not invoiced, the center does not get paid. This page explains how billing works and how to use the system to stay on top of it every day.

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Before You Start

  • You need the Healthcare Administrator role to create and manage invoices.
  • Billing items must be linked to Appointment Types, Clinical Procedure Templates, and Lab Test Templates.
  • Healthcare Settings must be configured for your billing preferences.

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What Gets Billed at an Eye Care Center

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The Billing Workflow

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Billing for Eye Examinations

The “Appointments to Bill” number card shows completed appointments not yet invoiced. To invoice a completed eye examination:
  1. Open the Patient Appointment record
  2. Click Create Invoice
  3. The consultation fee auto-fills from the Appointment Type billing item
  4. Add any investigations ordered at the same visit (OCT, visual fields, etc.)
  5. Collect payment and submit the invoice
  6. The appointment’s Invoiced field ticks

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Billing for Investigations (OCT, Visual Fields, etc.)

Each Clinical Procedure (investigation) has an Invoiced field. To find unbilled investigations:
  1. Go to Clinical Procedure list
  2. Filter by Invoiced = No
Add the investigation to the same Sales Invoice as the consultation for the same visit.

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Billing for Surgical Procedures

Surgical billing is typically more complex and may involve multiple billing components: For insurance-covered surgical patients:
  • Get pre-authorization from the insurance company before the procedure
  • Note the authorization code in the clinical notes or the appointment record
  • The invoice is submitted to the insurance company with supporting documents

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Billing for Intravitreal Injections

Intravitreal injections are typically billed as:
  • Injection procedure fee
  • Drug cost (which can be significant - e.g., anti-VEGF drugs like Bevacizumab or Ranibizumab)
If the drug cost is significant and tracked separately from the procedure fee, set up two billing items: one for the procedure and one for the drug. Add both to the same invoice.

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Fee Validity (Free Follow-ups)

After a paid consultation, patients may qualify for free follow-up visits within a set period. This is particularly relevant for:
  • Post-operative follow-ups within the first month of cataract surgery (if included in the surgical package)
  • Free review after starting a new medication (e.g., new glaucoma drops)
Configure in Healthcare Settings:
  • Turn on Enable Free Follow-ups
  • Set Valid Number of Days
  • Set Number of Encounters in Valid Days
When the patient comes for the follow-up within the valid period, the consultation fee is waived automatically.

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Healthcare Settings: Billing Configuration for Eye Care

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Monitoring Billing

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Daily Check

At the end of each day:
  1. Check Appointments to Bill number card - should be zero
  2. Go to Clinical Procedure list → filter Invoiced = No → clear any unbilled investigations
  3. Go to Lab Test list → filter Invoiced = No → clear any unbilled tests

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Weekly Check

  1. Run Patient Appointment Analytics report to verify appointment volume vs invoice count match
  2. Review any credit notes or cancelled invoices

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Troubleshooting

A completed surgical procedure is not appearing in billing Check that the Clinical Procedure record has been submitted (not just saved). Only submitted records can be invoiced. Submit the record and then add it to the Sales Invoice. The patient says they already paid for an OCT but the system shows Invoiced = No The payment may have been collected outside the system, or the invoice was not linked to the patient. Check the sales invoice list for this patient’s customer record. Insurance requires the investigation to be pre-authorised but the doctor already ordered it The investigation can still be performed. Add a note to the Clinical Procedure record with the outcome (pre-auth pending, denied, or approved) and the insurance reference number. Submit the invoice to the insurance after receiving authorisation. The IOL cost is very high and the patient is querying the bill The IOL cost should be clearly itemised on the invoice as a separate line from the surgeon fee and OT charge. Open the Sales Invoice and confirm each line is described clearly.

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Best Practices

  • Invoice on the day of the visit - eye care patients often have multiple services in one visit (examination + OCT + visual fields) and bundling these on one invoice is easier to manage same-day than chasing them later
  • For surgical patients, collect pre-payment or insurance authorisation before the surgery date - having an outstanding large invoice creates collection problems post-surgery
  • Set up a surgical package billing item for your most common procedures (e.g., “Cataract Surgery Package - Right Eye”) that bundles the main components into one line - this simplifies invoicing and is easier for patients to understand
  • Always record the IOL type and power in both the clinical record and the invoice notes - this is needed for warranty claims if an IOL needs to be replaced
  • Post-operative follow-up fees should be discussed at the time of surgery, not at each follow-up visit - surprises at follow-up damage patient relationships