> ## 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 patient services are tracked, invoiced, and collected - from registration fees to therapy session charges and lab test billing.

Every service provided to a patient - consultation, therapy session, lab test, clinical procedure, inpatient stay - needs to be recorded and billed correctly. The billing module ensures nothing is missed and that every invoice reflects the actual care given.

***

## Before You Start

* You must have the **Healthcare Administrator** role to create and manage invoices.
* Billing items must be linked to each service type (set up in Therapy Types, Appointment Types, and Lab Test Templates).
* Healthcare Settings must be configured for your billing preferences.

***

## What Gets Billed in a Rehabilitation Center

| Service                          | When It Is Billed                             |
| -------------------------------- | --------------------------------------------- |
| Patient Registration             | At first registration (if fee is configured)  |
| Consultation (Patient Encounter) | After the encounter is submitted              |
| Therapy Session                  | After the session is submitted                |
| Lab Test                         | After the test is ordered or results approved |
| Clinical Procedure               | After the procedure is completed              |
| Inpatient Bed Charges            | Daily charge during admission                 |
| Inpatient Visit Charges          | When a doctor visits an admitted patient      |

***

## The Billing Workflow

```
Service is provided (appointment, session, lab, procedure)
         │
         ▼
Record is submitted in the system
(Encounter, Therapy Session, Lab Test, etc.)
         │
         ▼
"Appointments to Bill" or unbilled records accumulate
         │
         ▼
Front Desk / Billing creates a Sales Invoice
Links the invoice to the patient (customer record)
Adds all billable services to the invoice
         │
         ▼
Payment collected (cash, card, insurance)
Invoice marked as paid
         │
         ▼
Service records update to "Invoiced" status
```

***

## Registration Fee

If your center charges a fee for new patient registration:

1. In Healthcare Settings → tick **Collect Fee for Patient Registration**
2. Set the **Registration Fee** amount
3. When a new patient is registered, a payment popup appears (if "Show Payment Popup" is on)
4. The front desk collects the fee and records the payment

***

## Appointment Billing

Every appointment can be linked to an invoice. The "Appointments to Bill" number card on the workspace shows how many appointments are completed but not yet invoiced.

### How to Invoice Completed Appointments

1. Open the Patient Appointment record
2. Use the "Create Invoice" button (or go to Sales Invoice → New)
3. Link the invoice to the patient's customer record
4. The appointment's billing item and amount auto-fill from the Appointment Type configuration
5. Collect payment and submit the invoice
6. The appointment's "Invoiced" field ticks automatically

***

## Therapy Session Billing

Each submitted Therapy Session has an "Invoiced" field. Sessions where "Invoiced" is unticked are awaiting billing.

The rate per session is set in the Therapy Type record.

### How to Find Unbilled Sessions

1. Go to Healthcare workspace → Rehabilitation → **Therapy Session**
2. Filter by **Invoiced = No** and date range
3. Create a Sales Invoice for each session (or group multiple sessions on one invoice for a patient)

***

## Lab Test Billing

Lab tests can be invoiced in two ways depending on Healthcare Settings:

**Option 1: Bill when the lab test is ordered**

* When the doctor orders a lab test in the Patient Encounter, the front desk immediately creates an invoice before the sample is collected
* If "Process Service Request Only If Billing Status Is Paid" is on, the lab only starts processing after payment is confirmed

**Option 2: Bill after results are available**

* The front desk invoices the test after results are approved and printed

***

## Inpatient Billing

For admitted patients, billing covers:

* **Inpatient Visit Charges**: set up in Healthcare Settings → Inpatient Visit Charge Item - charged when a doctor visits the patient
* **Bed/Room Charges**: configured as a service unit item - charged per day in the bed
* **Medication**: drug costs charged separately
* **Therapy sessions**: invoiced as normal per session
* **Lab tests**: invoiced as normal per test

At discharge, the billing team creates a final consolidated invoice covering the entire inpatient stay.

***

## Fee Validity (Free Follow-ups)

When a patient pays for a consultation and returns within the valid window for a follow-up:

1. The system creates a **Fee Validity** record when the first payment is made
2. On the follow-up appointment, the system checks whether the fee validity is still active
3. If valid: no consultation fee is charged for the follow-up
4. If expired (past the valid days): normal consultation fee applies

This is configured in Healthcare Settings:

* **Enable Free Follow-ups**: turn on to activate
* **Valid Number of Days**: how many days the free follow-up window lasts
* **Number of Patient Encounters in Valid Days**: how many free follow-ups are included

***

## Healthcare Settings: Billing Configuration

| Setting                                   | What It Controls                                                       |
| ----------------------------------------- | ---------------------------------------------------------------------- |
| Collect Registration Fee                  | Whether to charge for new patient registration                         |
| Registration Fee                          | The amount to charge for registration                                  |
| Show Payment Popup                        | Whether a payment collection popup appears at appropriate moments      |
| Enable Free Follow-ups                    | Whether follow-up visits within a period are free                      |
| Valid Number of Days                      | Duration of the free follow-up window                                  |
| Inpatient Visit Charge Item               | The billing item used for inpatient doctor visits                      |
| Out Patient Consulting Charge Item        | The billing item used for outpatient consultations                     |
| Clinical Procedure Consumable Item        | The item used to bill procedure consumables                            |
| Allow Discharge Despite Unbilled Services | If off, the patient cannot be discharged until all services are billed |
| Process Service Request Only If Paid      | If on, therapy/lab orders are not processed until the invoice is paid  |

***

## Monitoring Billing

### Appointments to Bill (Number Card)

Shows how many appointments are completed but not yet invoiced. Check this every day to prevent revenue from being missed.

**Where:** Healthcare workspace, top number cards

### Unbilled Therapy Sessions

Filter the Therapy Session list by Invoiced = No to find all sessions that need billing.

### Unbilled Lab Tests

Filter the Lab Test list by Invoiced = No to find all tests that need billing.

***

## Troubleshooting

**An appointment shows in "Appointments to Bill" but no invoice was created**
The appointment was completed but the billing team did not create an invoice. Open the appointment and create the invoice.

**The patient was discharged but outstanding charges still show**
Either "Allow Discharge Despite Unbilled Services" is on (which allows discharge even with unpaid charges), or some charges were missed at billing. Check the patient's invoice history and create any missing invoices.

**The lab test says "Invoiced" but the patient was not charged**
The invoiced field may have been ticked manually in error, or the invoice may have been cancelled. Check the patient's invoice list in the BAS Finance module.

**I cannot create an invoice for a therapy session**
Check that the Therapy Type has a billing item set up and that it is marked "Is Billable". If "Is Billable" is off for the therapy type, no billing is triggered.

***

## Best Practices

* Invoice completed appointments same-day - the longer you wait, the easier it is to miss them
* For inpatients, do a billing review every 2-3 days during the stay rather than leaving everything to discharge day
* Turn on "Process Service Request Only If Paid" if your center requires upfront payment before therapy begins - this prevents unbilled services from accumulating
* Use the "Appointments to Bill" number card as your daily billing checklist - when it reaches zero, billing for the day is caught up
* If a patient is paying by insurance, confirm the insurance approval before the service is delivered and note the approval reference in the appointment or encounter

***

## Related Features

* [Appointments](/health-wellness/rehabilitation-center/appointments): Appointments are the primary billing trigger for outpatients
* [Therapy Plans and Sessions](/health-wellness/rehabilitation-center/therapy-plans-sessions): Therapy sessions generate the bulk of rehabilitation billing
* [Laboratory](/health-wellness/rehabilitation-center/laboratory): Lab tests have their own billing workflow
* [Inpatient Management](/health-wellness/rehabilitation-center/inpatient-management): Inpatient billing is more complex and needs daily attention