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.

The ledger displays the patient transactions, balance, and Patient Due and Insurance Due amounts (Estimations are based on Insurance Plan Allowance tables or Ortho Contract responsibilities). To sort the transaction list, click on the column heads.

Select a transaction line item to view additional details. To adjust or remove charges, select a transaction, and then select Adjust This Charge. For more information, see How to Adjust or Remove Charges on the Patient Ledger.

To filter the list by transaction type:

1. To change the transaction type, select All Types, and select one or multiple options from the Transaction Type drop-down list.
2. Click Save, and the transaction list narrows to the relevant line items.
3. Click Reset to restore the transaction list to the full list.

To search for a specific transaction, enter information, such as a service date or transaction amount, into the Search Transactions field, and the list narrows automatically as you type.

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

Under the Actions menu, select from the following options:

• New Charge: post new charges.
• New Payment: post new payments.
• Post Completed Work: post charges for previously completed work.
• Adjust Balance: adjust the balance, such as for discounts, write-offs, and refunds.
• Create New Claim: create a new insurance claim.
  Note: This option is active only when unbilled procedures exist, and it displays the number of eligible procedures.
• Print Billing Statement: print a billing statement as a .PDF file.
• Print Account History: print account history as a .PDF file.

Guarantor Ledger View

The Patient Ledger provides the ability to view and bill accounts by guarantor.
When multiple patient accounts are combined under one guarantor, you can print a billing statement or account history for the group.

When a patient is a guarantor for another patient or multiple patients, their ledger displays a Guarantor For option alongside the default Patient Name ledger option. When the patient is their own guarantor and is not responsible for any guarantees, only one ledger view available.

The number of guarantees is indicated in parentheses next to Guarantor For. Select the Guarantor For option to display the combined balance overview that the guarantor is responsible for, as well as the individual patient balances for the guarantor and guarantees.

When a patient is not their own guarantor, the patient ledger displays a Guaranteed By option alongside the Patient Name ledger option.

Select the Guaranteed By option to view the combined balance overview for the patient’s guarantor, as well as details regarding the patient’s current balance.

Note: Detailed transaction line items are not included in the Guarantor For or Guaranteed By view. To see a patient's individual transactions, open the Patient Name ledger.

The Actions menu within the Guarantor For and Guaranteed By ledger views is reduced to three options:

• New Payment
• Print Billing Statement
• Print Account History

Note: In some cases, there may be both Guarantor For and Guaranteed By ledger views if the patient is a guarantor for other patients, but is guaranteed by an individual other than themselves.

To edit the guarantor for a patient:

1. Navigate to Patient > Patient Record.
2. Select Edit Patient Record, and then scroll to the Responsible Parties section.
3. Select the Guarantor indicator (green star), next to the appropriate party, to assign a guarantor. The star is filled with green when selected or filled with white when deselected.
   Note: You can also check Is Self-Responsible to make the patient their own guarantor, or select Add New Responsible Parties, if the responsible party is not already included in the patient’s record.
4. Click Save Patient.

See Patient Statements with Multiple Responsible Parties for more information.

Post Charges from the Ledger

To post charges:

1. Under Actions, select New Charge. The Post New Charges window is displayed.
2. Use the Search Procedures field to find and select a procedure.
3. Verify or correct the indicated Location, Provider, and Amount.
4. When required, enter the Tooth/Quad and Surface for the procedure.
5. Repeat Steps 1-4 for additional charges.
6. Click Post Charges & Bill Ins.

For more information, see How to Post Charges and Payments From the Patient Ledger.

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. Under Actions, click New Payment. The Post New Payment window is displayed with the patient's balance.
2. 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.
3. In the Amount Paid field, enter the payment amount.
4. Verify or correct the Location and Date fields.
5. 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.
6. Use the Reference and Comments fields as needed for additional information.
7. Verify that the Payment Amount is correct.
8. 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. 

Print Billing Statement

You can print a billing statement for an individual or print a billing statement for a group, which includes all the balances for which a guarantor is responsible, from the patient ledger.

For more information, see How to Print a Billing Statement and How to Print a Group Billing Statement. 

Print Account History

You can print an account history for an individual or group from the patient ledger.

To print an individual account history:

1. Select the Patient Name.
2. Select Print Account History. A report is generated for the selected patient.

To print a group account history:

1. Select Guarantor For or Guaranteed By.
2. Select Print Account History. A Guarantor Account History report is generated for the entire group, with entries sorted by patient.

For more information, see How to Print a Patient Account History.