> ## 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 home visits, nursing procedures, blood tests, and pharmacy medicines - and how to make sure nothing goes unbilled at the end of each day.
Every service delivered by your home care team needs to be invoiced. If a nurse visits a patient, changes their wound dressing, and the doctor prescribes a medicine - all three of those things need to appear on a bill. This page explains how billing works in the home care system and how to check that nothing has been missed at the end of each day.
***
## Before You Start
* Billing items must be linked to appointment types, clinical procedure templates, and lab test templates.
* You need the **Healthcare Administrator** role to create sales invoices.
***
## What Gets Billed
| Service | When It Is Billed |
| ------------------------------------------ | --------------------------------------------------- |
| Patient Registration Fee | At first registration (if your service charges one) |
| Home Visit Fee (Consultation) | After the visit record is submitted |
| Wound Dressing Procedure | After the clinical procedure is submitted |
| Blood Test (Collection and Lab) | After the lab test is ordered or completed |
| Medicines from the Pharmacy | At the pharmacy counter using the POS system |
| Medical Consumables (if billed separately) | After the clinical procedure is submitted |
| Any other procedure or service | After the relevant record is submitted |
***
## How the Billing Process Works
```
Caregiver completes the visit and submits all records
(Patient Encounter, Clinical Procedure, Vital Signs, Observations)
│
▼
Visit appears in the "Appointments to Bill" count
│
▼
Care Coordinator opens a Sales Invoice
Links it to the patient's customer account
Adds all services from this visit
│
▼
Patient or family member pays (cash, card, or bank transfer)
Invoice is submitted
│
▼
Visit is marked as Invoiced
Appointments to Bill count goes down by one
```
***
## Creating a Bill for a Visit
### Step 1: Open a New Sales Invoice
1. From the main Bizaxl menu, go to **Accounting** workspace → **Sales Invoice** → New
Or, from the Patient Appointment record, click **Create Invoice** to pre-fill the patient and visit details automatically.
### Step 2: Link to the Patient
In the **Customer** field, search for and select the patient's customer account. This was created automatically when the patient was registered.
### Step 3: Add All Services from the Visit
In the **Items** table, add a row for each service:
| Service | How to Add It |
| ---------------------------------- | ---------------------------------------------------------------- |
| Home visit consultation fee | Select the billing item for "Home Consultation" or "Out-patient" |
| Wound dressing procedure | Select "Wound Dressing (Home Visit)" as the item |
| Blood test | Select the lab test item |
| Consumables (if billed separately) | Select each consumable item used |
The price for each item is pulled automatically from the system's price list.
### Step 4: Collect Payment and Submit
1. Confirm the total amount with the patient or family
2. Record the payment method (Cash / Card / Bank Transfer / Insurance)
3. Click **Submit**
After submission:
* The patient's outstanding balance is updated
* The relevant clinical records are marked as Invoiced
* The "Appointments to Bill" number goes down
***
## Pharmacy Billing
Medicines dispensed at the pharmacy counter are billed directly through the POS system at the time of dispensing - not through the Sales Invoice. The pharmacy generates its own POS Invoice for each transaction. See [Medications and Pharmacy](/health-wellness/homecare-services/medications-pharmacy) for details.
***
## What Does "Appointments to Bill" Mean?
The **Appointments to Bill** number card shows you how many completed visits have not yet been invoiced. You want this number to be zero at the end of every day.
To see which specific visits are unbilled:
1. Go to Home Care workspace → Consultation section → **Patient Appointment**
2. Filter by: Status = Closed, Invoiced = No
This gives you the exact list of visits that still need an invoice.
***
## Tracking Patient Balances
To see what a patient owes:
1. From the main Bizaxl menu, go to **Accounting** workspace
2. Open **Accounts Receivable** report
3. Filter by the patient's customer account
This shows all outstanding invoices for the patient with the amount due.
***
## Insurance and Corporate Billing
For patients whose care is covered by an insurance company or a corporate employer:
1. Record the insurance or corporate details in the patient record (in the notes or a custom field)
2. Raise the Sales Invoice as normal
3. Set the payment type to "Insurance" or "Corporate Account"
4. Submit the invoice
5. Send the invoice to the insurance company or employer separately (printed or by email)
6. When payment is received, record it as a payment entry against the invoice
***
## Healthcare Settings: Billing Configuration
The following settings in Healthcare Settings affect billing:
| Setting | What It Controls | Recommendation |
| ----------------------------------------- | ---------------------------------------------------------------------------------- | --------------------------------------------------------------------- |
| Collect Registration Fee | Charges a one-time fee when a patient is registered | Enable if your service charges an onboarding fee |
| Registration Fee | The amount to charge | Set to your registration rate |
| Out Patient Consulting Charge Item | The billing item for home visit consultations | Link to your Home Consultation billing item |
| Clinical Procedure Consumable Item | The billing item for procedure consumables | Link to your general supplies billing item |
| Show Payment Popup | Shows a payment prompt when billing is done | Enable for front-desk payment collection |
| Allow Discharge Despite Unbilled Services | Allows a patient to be discharged from inpatient status before billing is complete | Disable (billing should be cleared before closing a case) |
| Enable Free Follow-ups | Allows certain follow-up visits to be free within a time window | Enable if your service includes free revisits within a package period |
***
## Checking Billing at the End of the Day
Use this quick check before finishing each day:
| Check | How to Do It | Target |
| ------------------------------------ | ------------------------------------------- | ------------------------------------------------ |
| Appointments to Bill | Check the number card on the dashboard | Zero |
| Procedures not invoiced | Filter Clinical Procedures by Invoiced = No | Zero |
| Pharmacy closing done | Complete POS Closing Entry | Done |
| Lab tests ordered but not yet billed | Check Lab Test list for Invoiced = No | Zero or noted for next day when results are back |
***
## Best Practices
* Bill on the same day as the visit - do not leave invoicing for the end of the week. It is harder to track what happened when time passes, and patients or their families expect to receive the bill promptly
* For patients who pay monthly (package pricing), set up a recurring invoice schedule and issue one invoice per month rather than per visit
* For patients covered by insurance, always confirm the coverage before starting care - ask the family to provide the insurance card details and verify coverage with the insurer before the first visit
* Keep the billing items and their prices up to date - if you change your visit fee, update it in the system immediately so every invoice after that date shows the correct amount
***
## Troubleshooting
**A visit is showing as Closed but still appearing in "Appointments to Bill"**
This means the visit record was submitted but no invoice was created. Open the Patient Appointment record, confirm the status is Closed, and then create a Sales Invoice for the visit.
**The wrong amount was charged on an invoice that has already been submitted**
You cannot edit a submitted invoice directly. Create a **Credit Note** against the original invoice to reverse the incorrect amount, then raise a new invoice with the correct amount. Both the credit note and the new invoice are kept in the system for audit purposes.
**A patient says they already paid but the system still shows an outstanding balance**
Check whether a payment entry was created for this patient. The invoice may have been submitted but the payment may not have been recorded. Create a Payment Entry against the invoice if the payment was genuinely received but not entered.
***
## Related Features
* [Scheduling Visits](/health-wellness/homecare-services/scheduling-visits): Visits are the primary billing trigger
* [Nursing Care](/health-wellness/homecare-services/nursing-care): Procedure fees and consumables are billed after procedure submission
* [Laboratory](/health-wellness/homecare-services/laboratory): Blood test fees are billed after test completion
* [Medications and Pharmacy](/health-wellness/homecare-services/medications-pharmacy): Pharmacy sales are billed through the POS system
* [Care Settings](/health-wellness/homecare-services/care-settings): Billing configuration in Healthcare Settings