This helpful guide will walk you through our Account Ledger feature!
Table of Contents
📓 Please Note: For staff to access the Financials & Account Ledger screens, a hospital administrator must add at least one of the following permissions to your preferred user roles: Payment Record, Payment Refund, Payment Void, or Financial Ledger. Users who only have the Financial Ledger permission added to their role will have view-only access of the Account Ledger screen. In addition, your hospital must also have our Payments feature previously enabled by contacting us at support@instinct.vet.
📒 Account Ledger
The Account Ledger displays Account Information, visit invoices and transactions for all patients in the Account, as well as their Account Balance and Balance ages (over 30, 60, 90, and 120 days). There are three ways to navigate to the Account Ledger screen:
- Clicking ‘Business Office’ > ‘Financials’ > then searching/selecting an Account.
- Clicking on the ‘Payments & Ledger’ button on the patient’s Invoice screen.
- Clicking on the ‘Three Dot Menu’ icon next to a patient’s name > ‘Payments & Ledger’
In the Financials section of the Business Office, each column can be sorted using the carrot (downward pointed triangle) to the right of the column in descending or ascending order.
You can also search by the Account name in the Financials screen using the search bar in the top right. By default, this screen will only display Accounts that have Balances; however, you can always search any Account in the database if needed.
Clicking ‘Edit’ in the 3-dot menu next to the Account ID will bring up the Account information to easily view or update any Account information.
Hovering over the Account name will display all associated patients to that Account in a tooltip text, and clicking anywhere on the Account row will open up the Account Ledger for that Account.

Once in the Account Ledger for that Account, the top section of the Ledger will contain the Account information and the Account Balance totals, any Account Credits, and Balance ages.

You can also Filter the ledger rows by Transaction Type, Payment Method, Invoice, and Patient.

Clicking on any transaction row will open up the Payments Pane to the right, and clicking on any Visit Invoice row will open up the selected Invoice screen for the patient.
A helpful tooltip will also display when hovering over rows. Transaction rows will display Transaction details as well as any Transaction Notes entered with the Payment.
The footer section of the Account Ledger works as follows:
- Payments: Opens the Payments Pane on the right hand side.
- Print Statement: Exports a PDF of the Account Ledger to print.
- Totals Section: Displays the total Credit, Debit, and Balance of all the Ledger rows, with the amounts updating as financial data changes.
💰 Payments
All Payment transactions are processed through the patient’s Account Ledger screen, either by navigating through Business Office > Financials > then searching/selecting an Account, clicking on the Payments & Ledger button on the patient’s Invoice screen, or by selected ‘Payments & Ledger’ option from the three dot menu next to a patient’s name.
The Payments pane will open on the right hand side for you to capture a Payment, and the patient name and invoice number will already be selected.

You can also make a payment by navigating to the Business Office > Financials > clicking on the Account row > selecting ‘Payments’ at the bottom of the screen. The Payments Pane will open on the right and the Patient can be selected from the drop down field. Once a patient is selected, the rest of the fields (previously grayed out) will become available.

📓 Please Note: The Patient drop down field will only display patients associated to the account that have had previous visits or an active visit.
The Account Statement can be printed by clicking Print Statement at the bottom of the Account Ledger and selecting an option.

Once selected, you will see a notification on the bottom left of the screen indicating that the PDF is being exported
The PDF will contain the entire Account Ledger history, including Visit Invoices and all transaction rows indicating a Debit or Credit amount.

📓 Please Note: The printed Account Statement will not display any voided transaction rows.
💡 Visit our full EMR Invoice Guide or our Account Deposits, Account Credits, and Unapplied Payments Guide!
🧠Test your knowledge with our Careville Quiz!