How to Work With the Patient Ledger

 Related Training
Posting Charges, Payments, and Adjustments Recorded Class

Charges and payments are posted to the Patient Ledger during the checkout process following an appointment. When you select the patient from the Checkout Queue, you are prompted to post charges (Post New Charges window) and take payments (Post New Payment window) based on the procedures performed during the appointment. 

You can also access the Patient Ledger at any time by selecting Patient tab > Financials > Ledger.

From the Ledger, you can:

• Post new charges.
• Post new payments.
• View and sort the list by clicking the column heads.
• View the Insurance Due and Patient Due amounts. (Estimations are based on Insurance Plan Allowance tables or Ortho Contract responsibilities.) 
• View balance details when sorting by Transaction date.
• Filter the list by Transaction Type.
• Search transactions.
• Adjust the balance, such as for discounts, write-offs, and refunds.
• Adjust or remove charges. For more information, see How to Adjust or Remove Charges on the Patient Ledger.
• Post charges for previously completed work. (When unposted procedures exist, you are prompted to review and address them.)
• Create a new claim. (When unbilled procedures exist, this option is active and displays the number of eligible procedures.)
• Print a Billing Statement or Account History as a .PDF file.

Note: Sensei Cloud enables you to customize the Ledger by color-coding transaction types. For more information, see How to Color-Code Ledger Transactions.  

Post Charges from the Ledger

To post charges from the Ledger:

1. From the Patient tab, select Financials > Ledger.
2. Select New Charge. The Post New Charges window is displayed.
   Note: If unposted procedures exist from completed work, you are prompted to address them before posting new charges.
   
   Click Review Existing to view and post those charges, or click Post New to continue, and address the unposted procedures later. 
3. Use the Search to Add Procedures field to find and select a procedure.
   -- Bill Ins? is selected automatically when the patient has insurance, and a new claim is created when charges are posted. If not selected, you can access them and create the claim later from Actions > Create New Claim, or Location > To Do > Unbilled Procedures.
   --The Service Date defaults to today, or to the date of service for previously completed work. You can edit the date when posting a new charge for a prior date, but not for previously completed work.
   --The Location and Provider fields are populated automatically with the patient's preferences, when defined in the Patient Record. You can edit the provider if necessary, but the location cannot be changed for previously completed work.
   --The Amount field is populated automatically from the Procedure List and Fee Schedule. If you enter a different amount, you are prompted to verify the standard office fee.
4. When required, enter the Tooth/Quad and Surface for the procedure.
5. Repeat Steps 1-4 for additional charges.
6. Click Post Charges and Bill Ins.

Post Payments from the Ledger

Insurance payments are deducted from the Insurance Due amount, and patient payments reduce the Patient Due amount. 

To post a payment from the Ledger:

1. From the Patient tab, select Financials > Ledger.
2. Under Actions, click New Payment. The Post New Payment window is displayed with the patient's balance.
3. If the payment is a split payment intended to cover charges for multiple patients, such as family members who are connected, use the Search field to select one or more connected patients. For more information, see How to Post a Split Payment. 
4. In the Amount Paid field, enter the payment amount.
5. Verify or correct the Location and Date fields.
6. Select a Payment Type from the list. If you select Insurance - Check, Insurance-Credit Card, or Insurance-EFT, you are prompted to select a claim, and the Claim Number is automatically added to the transaction details upon posting.
7. Use the Reference and Comments fields as needed for additional information.
8. Verify that the Payment Amount is correct.
9. Click Post Payment. The credit is added to the patient ledger.

Important: When you are signed up to use ePayments Secure for Sensei Cloud, the posting process is different. For more information, see ePayments Overview, and the ePayments Secure for Sensei Cloud Getting Started Guide in the Carestream Dental Institute.