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Every service provided at the clinic needs to reach an invoice: consultations, lab tests, procedures, inpatient bed charges. If something is not invoiced, the clinic does not get paid. This page explains how billing works, what to do each day to keep invoicing up to date, and how the system helps you track what is pending.

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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, lab test templates, and procedure templates.
  • Healthcare Settings must be configured for your billing preferences.

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What Gets Billed at a General Clinic

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The Billing Workflow

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Registration Fee

If your clinic collects a fee when a new patient registers:
  1. In Healthcare Settings, tick Collect Fee for Patient Registration and enter the fee amount
  2. When a new patient record is saved, a payment collection popup appears automatically
  3. The front desk collects the fee and records the payment

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Billing for Consultations

The “Appointments to Bill” number card on the workspace shows how many completed appointments still need invoicing. How to invoice a completed appointment:
  1. Open the Patient Appointment record
  2. Click Create Invoice or go to Sales Invoice → New
  3. Link the invoice to the patient’s customer record
  4. The consultation fee auto-fills from the Appointment Type billing item
  5. Add any other services from the same visit (lab fees, procedure fees)
  6. Collect payment and submit the invoice
  7. The appointment’s Invoiced field ticks automatically

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Billing for Lab Tests

Lab tests can be invoiced in one of two ways, depending on your clinic’s policy: Pre-payment (before processing):
  • When the doctor orders the lab test in the consultation, the front desk creates an invoice before the sample is collected
  • If “Process Service Request Only If Billing Status Is Paid” is on, the lab only starts the test after the invoice is paid
  • Use this when your clinic requires payment before services are rendered
Post-payment (after results are available):
  • The front desk invoices the test after results are entered and approved
  • Use this when patients are billed at the end of the visit for everything they received
To find unbilled lab tests: go to Lab Test list and filter by Invoiced = No.

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Billing for Clinical Procedures

Each Clinical Procedure record has an Invoiced field. Procedures where Invoiced is unticked are awaiting billing. If consumables are billed separately (set in the Clinical Procedure Template):
  • The procedure fee and the consumable cost appear as separate line items on the invoice
  • The Consumption Invoiced field tracks whether consumable costs have been billed

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Billing for Diagnostic Reports and Observations

Billable Observation records have an Invoiced field. The billing rate is set on the Observation Template. To find unbilled observations: go to the Observation list and filter by Invoiced = No.

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Billing for Inpatients

For admitted patients, billing typically happens at discharge and covers the full stay:
  • Bed charges: set up as a service unit billing item in Healthcare Settings (Inpatient Visit Charge Item)
  • Doctor visit charges: the rate per visit is on the Healthcare Practitioner record or the Healthcare Settings
  • Medications: drug costs are added as separate line items
  • Lab tests and procedures: invoiced as normal per test/procedure
At discharge, the billing team creates a consolidated invoice for the entire stay. If “Allow Discharge Despite Unbilled Healthcare Services” is off in settings, billing must be complete before the Inpatient Record can be submitted for discharge.

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Fee Validity (Free Follow-ups)

When a patient pays for a consultation, they may be entitled to free follow-up visits within a specified number of days:
  1. After payment, the system creates a Fee Validity record
  2. On the follow-up appointment, the system checks if a valid Fee Validity exists for this patient and practitioner
  3. If valid: consultation fee is waived
  4. If expired: normal fee applies
Fee Validity statuses: Active, Expired, Completed, Cancelled Configure in Healthcare Settings:
  • Turn on Enable Free Follow-ups
  • Set Valid Number of Days (e.g., 7 days for a free follow-up)
  • Set Number of Patient Encounters in Valid Days (e.g., 2 free follow-ups)

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Healthcare Settings: Billing Configuration

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Monitoring Billing

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Appointments to Bill (Number Card)

This is your most important daily billing metric. Check it every morning. When it reaches zero, all completed appointments for the day are invoiced. Found on: Healthcare workspace, top number cards.

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Unbilled Lab Tests

Go to Lab Test list → filter by Invoiced = No → check daily.

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Unbilled Procedures

Go to Clinical Procedure list → filter by Invoiced = No → check daily.

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Unbilled Observations

Go to Observation list → filter by Invoiced = No → check at end of each day.

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Troubleshooting

An appointment shows in “Appointments to Bill” but billing says no invoice was created The appointment was completed without an invoice. Open the appointment and create the Sales Invoice. The Invoiced field on a consultation did not tick after creating the invoice The Sales Invoice must be submitted (not just saved) for the Invoiced field to update. Submit the invoice and check again. A patient was discharged but some charges are still showing as unbilled Either “Allow Discharge Despite Unbilled Services” was on (which permits discharge even with outstanding charges), or some services were missed. Check the patient’s unbilled records in each list and invoice them. The fee validity is not being applied to the follow-up appointment Check that “Enable Free Follow-ups” is on in Healthcare Settings. Also verify that the follow-up appointment is with the same practitioner that the original consultation was with (Fee Validity is practitioner-specific).

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Best Practices

  • Invoice completed appointments the same day - the longer you wait, the easier it is to miss something
  • Use the “Appointments to Bill” number card as your daily completion checkpoint - zero means billing is caught up
  • For inpatients, do a billing review every 2-3 days rather than leaving everything to discharge day
  • Turn on “Process Service Request Only If Paid” if your clinic requires upfront payment before services are delivered
  • Always link the Sales Invoice to the patient record (via the Customer field) - invoices that are not linked cannot be found in patient history