Charges are the production ledger: every completed visit, and anything else you bill, is a charge on the client's account. Find them on the client's Billing tab, below the billing profile, next to the client's Invoices and superbills.
How charges are created
- Automatically, when an appointment is marked completed: one charge per client (one per attended client for a group), dated on the visit, with the service's billing code and modifiers, the provider, the place of service (office, or telehealth when the service is virtual), and the fee that was resolved for the visit. Signing a clinical note linked to the visit links or captures the same charge, dated on the visit; it is never duplicated, and a cancelled or no-show visit never gets one.
- By hand, with Add charge: service date, a code searched from the catalog (the description, units, fee, and place of service fill in), the fee, units, provider, diagnosis pointers, and notes.
Either way, the client's share of the charge goes on their balance. Money they paid toward the visit before it was completed (a copay at check-in) counts as already paid, so it isn't owed twice. Charge dates are calendar days: a charge dated September 12 shows as September 12 whatever your time zone.
A charge whose fee is unknown is created as a Draft for you to price; see Set client fees and rates. Charges also record the client's share of the fee (the copay for insurance clients), which is what autopay charges.
Reading the list
The toolbar has a date range (last 30 days, this month, last month, this year, last year), Add charge, and a New ▾ menu for a Superbill or an Invoice. Each charge shows its description, code, date and units, fee, and a status:
| Status | Meaning |
|---|---|
| Unpaid | Nothing paid yet |
| Partial | Some of the fee paid or adjusted |
| Paid | Fully settled |
| Draft | No fee yet; not on superbills unless you include drafts |
| Void | Removed; kept for the record |
Click a charge to edit it; Void asks for confirmation. Voiding a charge and Adjust balance are for the account owner, admins, practice managers and billers; for anyone else the balance strip says so. Once a charge isn't a draft, changing its fee or billing code (which fills in a fee) is theirs too: anyone else sees both locked, with the reason, and can still edit the rest.
A view-only member can open a charge but not change it, and doesn't get Add charge or New → Invoice; they can still make a superbill. The client's Billing screen in the FrontDesk phone app works the same way.
Settling a charge without a payment
Adjust balance on the balance strip records a write-off, discount, courtesy adjustment, insurance adjustment, or correction with a reason. Only a correction can be negative, to add an amount back. Every adjustment is a row in the ledger the financial reports read.
Pick a Charge (optional) to adjust one line instead of the whole balance, for example to discount one visit:
- The amount can be at most the client's share still open on that charge (their copay for an insured visit, not the whole fee). The window says how much can come off.
- A draft invoice billing that charge follows the new amount.
- An invoice already sent for it is refused: that invoice has to be voided first, then you adjust the charge and send a new one. The picker warns you when that's the case. Open the invoice from the Invoices card on the Billing tab (or Payments → Invoices) and use Void; see Invoices.
What charges feed
- Superbills list charges as line items with their diagnosis pointers; see Create and send superbills.
- Invoices bill visit charges with Add visit charges, and paying the invoice pays those visits. The client's invoices are listed in the Invoices card on the Billing tab; see Invoices.
- Payments settle charges: a payment tied to the visit, an autopay charge, a portal payment, a pay link, a payment at the desk, or a payment-plan installment. A payment for no particular visit pays the open charges on no invoice first, oldest first, then the client's open invoices oldest first, through the invoice (so the invoice shows it as paid and its pay link closes when it is paid in full). Money left over is held as credit on account. See Take patient payments.
- Reports count charges as production and unpaid charges as open A/R.
Practices connected to athenahealth keep their previous charge capture rule and none of the rate screens.