Use this helpful guide to learn how to build/edit invoices, document payments, and use invoice tags for reporting within the Instinct Invoice.
💡 ProTip: Refer to our Taxes Guide and Discounts Guide for detailed information on how Instinct handles Taxes/Discounts!
Table of Contents
➕ Adding Invoice Line Items
First, Instinct will continue to automatically populate the Instinct Invoice from completed treatments and automatic charges. You can also add items directly to the Invoice, too!
To add items directly to a Patient Invoice, simply search by Product Name or PIMS ID. You can edit the Label, Quantity, Dr., and Price until the patient is Checked Out. Click the orange checkmark to add an item to the patient invoice or click the grey “x” to cancel.
Please note that any items added directly to the Invoice do not impact current/scheduled treatments. This means if something is added directly to the invoice but is also scheduled and completed on the treatment sheet, both charges will then appear on the Invoice (they won’t cancel eachother).
It is also important to note that while you can add any item to the invoice directly, any associated automatic charges will not appear on the invoice unless entered separately. For instance, if ‘IV fluids’ with an automatic charge is added to the invoice, the automatic charge would need to be added separately.
Adding Invoice Product Groups
Invoice Product Groups are designed to help your team quickly load custom Product Groups onto a patient’s invoice. Here’s how it works:
1. Head to the Invoice screen and search for any Invoice Product Group you’d like to use.
💡 ProTip: Create separate ‘Invoice Groups’ that are specifically used for invoicing, such as a ‘Surgery Group Base’ or ‘Surgery – Fracture’ to include plates, anesthesia, etc. We’ll explain why you may not want to use your existing Treatment Sheet Product Groups in just a minute.
2. A doctor field is required in order to add items to the invoice and will default to the currently assigned doctor. If a doctor is not assigned yet, you’ll need to select one from the dropdown before adding the Invoice Product Group.
3. All billable items included in an Invoice Product Group will be added to the invoice.
💡 ProTip: This is why we recommend creating specific Invoice Product Groups and not using Treatment Sheet Product Groups:
* They may contain multiple billable options that are selected at the time of ordering (5mg Enalapril, 10mg Enalapril, etc.)
* You will be adding duplicate charges since Instinct captures charges from the Treatment Sheet as the items are updated/completed
* There may be automatic charges associated with Treatment Sheet Product Groups, different hospitalization options, etc.
* If a Treatment Sheet Product Group is selected on the invoice, any and all billable items will be included on the invoice by default.
💡 A few things to keep in mind
- If a non-billable order has an attached fee (like an automatic charge) – that fee will not be added to the invoice, but you can still add the fee manually to the invoice if desired!
- If a Product Group is added but does not contain any billable items, the following screen will appear:
✏️ Editing Items
Click the item itself, or the 3-dot menu next to any invoice item, and choose ‘edit’ to change the Time, Label, Quantity, Invoice Tags, Dr., and Price. Please note the PIMS ID is not editable.
💡 ProTip: Editing the Time, Quantity, Price, and Label of a completed treatment on the invoice will only change on the invoice—the original completed treatment details will remain on the Treatment Sheet and order history screen.
You can also view who created, voided, or un-voided individual invoice line items using the 3-dot menu within the Invoice screen.
You’ll then see the revision history below the line item.
💰 Payments Overview
Please note – this is a general overview of the Payments screen. Hospitals using Gravity Payments will also want to review the ‘Payments Screen – Gravity Payments’ section below.
To Record a payment, click ‘Payments’ to open the Payments screen on the right.
Visit Tab
The Visit tab is used for applying payments or refunds to a selected invoice for a selected patient under the owner’s account.
- Patient – Drop down menu including all patients associated with the client account
- Invoice – Drop down menu including all previous invoices for easy reference
- Type – Transaction Type, either Payment or Refund.
- Method – Accepted Methods for non-Gravity Payment customers include Cash, Visa, Mastercard, American Express, Discover, Check, Care Credit, Insurance and Other.
* Non-Gravity Payment customers must process Credit/Debit card transactions using your facility’s card terminals. The “Payment” module in Instinct Invoice merely documents that the transaction has been processed elsewhere.
** Gravity Payment customers will see a specific Credit/Debit Card option instead of displaying Visa, Mastercard, American Express, and Discover. These customers can process a card transaction directly from the Instinct Invoice using their Clover (Gravity) device. More on this below!
If processing via Credit/Debit Card, a Transaction ID field appears and is required.
If processing via Insurance, a required Insurance Type field and optional Transaction ID appear.
If processing via Other, the Notes field is required.
Amount – Select a dropdown to quickly enter the Current Balance, % of Balance, or % of Estimate in the Amount field. You can also enter any amount by typing it in directly.
Note – Notes field for all Methods. This is required for any ‘Other’ Payment Methods.
Once a payment has been processed, the Payments screen will update in real time and display a confirmation message as shown below.
You can then:
- Change to Inpatient – Update status of patient to ‘Inpatient’ if they’re not already listed as such
- Check Out – Check this patient out of Instinct
- Print Invoice – Download/print the current invoice
- New Transaction – Process a new transaction (helpful if owner uses multiple forms for payment)
Account Payoff Tab
The Account Payoff tab is used to apply payments across all patient visits with a current balance due that are associated with the client account.
The total Account Balance is shown and consists of all credits and balances due that are on the client’s Account Ledger.
Patient Visits will be display by check-in date and time from newest to oldest and will show the current visit balance due for each visit. Any visits that currently have a credit will not display on the Account Payoff tab.
A Payment made when there are multiple visit balances due will be applied to the oldest visit balance first, and any remaining payment will be applied to the next oldest and so on. The visit balance will display a preview of how the payment will be divided and what the new Account Balance will be.
📝 Please Note: The amount of payment can not be greater than the Account Balance. To apply a payment as a credit, go to the Visit tab and associate the payment to an individual visit.
Once the Transaction is Recorded:
- The Account Payoff tab will update and any visits that were paid off will no longer be visible on the tab.
- The Visit tab will update and display the transaction that was applied to any visits under each patient.
- The Account Ledger will update and display the transactions in one single line, with Multiple under the Invoice ID, Patient, and Provider columns. Hovering over this line will display a text box that will list the individual transactions made with Invoice ID, Patient Name and PIMS ID, and Amount.
🚨 Important Note: If the Account Balance is completely paid off and there were existing credits on patient invoices, the aging schedule will balance to zero instead of showing any negative amounts (credits). Credits can still be viewed on the Visit tab or on the associate patient invoice.
💳 Payments Screen – Gravity Payments
Hospitals with Gravity Payments can use your Clover device(s) to accept Credit/Debit card payments within Instinct. If you are not set up with Gravity Payments and would like to learn more, please contact Stacy Milazzo at stacy@instinct.vet. Hospitals not using Gravity Payments can skip to the ‘Payments View – Other Payment Processor’ section below.
To Initiate or Record a payment, click ‘Payments’ to open the Payments screen on the right.
Patient – Drop down menu including all patients associated with client account.
Invoice – Drop down menu including all previous invoices for easy reference.
Type – Transaction Type (either Payment or Refund)
Method – Accepted Methods include Credit/Debit Card, Cash, Check, Care Credit, Insurance and Other.
* If processing via Credit/Debit Card, a Terminal drop down appears to select which payment terminal will be used. This is a required field and Terminal options can be managed by your Admin team within Instinct.
💳 Initiating a Transaction via Credit/Debit Card with Gravity
After a Credit/Debit Card Method has been selected and all required fields are filled out, click the orange ‘Initiate Transaction’ button (shown in above screenshot) to send the transaction to the selected Terminal.
The Payments screen on the right side of the page will update letting you know the payment has been sent to the terminal as shown below.
A Gravity Payments pop-up will also appear with transaction details, option to Cancel the transaction, and option to add the credit card via Manual Entry.
Selecting Cancel simply cancels the transaction.
Selecting Manual Entry updates the Gravity pop-up so you can enter credit card information manually if needed (shown below). This is also available within the Terminal field by selecting ‘Direct Entry’.
Once a payment has been processed, the Payments screen will update in real time and display a confirmation message as shown below.
You can then:
- Change to Inpatient – Update status of patient to ‘Inpatient’ if they’re not already listed as such
- Check Out – Check this patient out of Instinct
- Print Invoice – Download/print the current invoice
- New Transaction – Process a new transaction (helpful if owner uses multiple forms for payment)
🧾 Patient Transaction History
For convenience, a historical log of all patient transactions is shown towards the bottom of the Payments screen, in reverse chronological order. Click the angle brackets as shown below to expand the Payment history for any visits.
Each visit is labeled by date, and includes information such as payment/refund method, ID/notes, and amount. The Invoice Total, Payments Total, and Visit Balance are also displayed.
❌ Voiding & Hover Text
Voiding
All payment types can be voided at any time, except for Gravity Payment transactions. Payments will have a 3-dot menu to the left of the date where you can ‘Void’ or ‘Copy Transaction ID’.
Account Payoff Payment Void
Payments that are made under the Account Payoff tab can also be voided if needed. To void these transactions, go to the Visit tab, select the patient and locate the transaction. Click on the 3-dot menu next to the transaction and select Void.
A display will pop up alerting that this is a partial payment that is tied to other partial payments on other visits, and voiding this payment will void all the other payments. All visits and amounts that were associated with the Account Payoff payment will be listed. Click on “Void” to confirm the void.
📝 Please Note: Account Payoff payments processed through Gravity that are in a status of Settled cannot be voided.
Gravity Payment Void
Gravity payments must be voided within 15 minutes of transaction completion, by clicking the 3-dot menu followed by “Void”. If more than 15 minutes has elapsed, a refund must be issued.
Please also note that once a Gravity Payment has been voided, you cannot undo this void. You would want to create a new transaction to resolve this.
Hover Text
Hovering over the payment will display specific details relating to that payment, including when it was Created, the Status of the payment, the Clover device used and status of transaction (if applicable), which user initiated the payment, and any notes.
🏷 Invoice Tags
Invoice tags can be added to any product/invoice item in the Admin screen, and they’ll allow you to quickly generate custom reports.
If a product/ invoice item has an Invoice tag, it will automatically display on the invoice when completed on the Treatment Sheet/One-off, or when a product is added directly to the invoice.
Managing Invoice Tags
Admin users can add and edit Invoice Tags by going to Admin > Invoice Tags. To remove an Invoice Tag, please contact us at support@instinct.vet.
To add Invoice Tags to a product, simply add them from the “Invoice Tags” field.
Note – Invoice tags can only be added to billable products.
Editing Invoice Tags
Invoice tags can be added/removed for any invoice line item by clicking the 3-dot menu > Edit. To save changes, click the orange checkmark.
Analytics – Invoice Tags
Invoice Tags are also included on the Revenue Details Report in a separate column as shown below:
As a reminder, this report is generated within the Analytics section of Instinct (left sidebar).
Use Invoice Tags for general ledger coding to report how much business was done for controlled drugs, anesthesia supplies, laboratory tests, and more! This is also helpful for AAHA Chart of Accounts, Revenue Centers, and Inventory Locations.
💡 Advanced Invoice Info
Adding Non-Billable Items
Non-billable items can be added to any Patient Invoice by Product Name or PIMS ID. The Price field will show $0 by default but if desired, a dollar amount can be entered.
Adding Automatic Charges
Adding items with an automatic charge attached (billable or non-billable) will not automatically add the automatic charge to the invoice along with the original item—only the original item will be added. If needed, automatic charges can be added directly to the invoice via Product Name or PIMS ID. If you need a refresher on automatic charges, click here!
💡 ProTip: All automatic charges are added once to the invoice—it will not trigger an automatic charge schedule to start charging.
Taking a deposit
In the admin section, you can create a product named “Deposit” with a zero charge.
Users can then select this product to add to the Invoice. By editing the Label, the user can put the amount of the deposit that will be taken, ie: Deposit of $1,000.00, in the Label to show the client and staff the amount that is being taken.
🚨Important! Leave the Deposit Price as $0.00. Putting any amount in this area will either add or subtract that amount from the Total Invoice Amount. This will result in either overcharging the client or providing the client with an unintentional discount!
Once this line item has been added, users can click on Payments & Ledger to be taken to the Payment window. They should apply the payment to the current Invoice and in the note section note that this is a Deposit.
Once the transaction has been recorded, the client account will reflect a credit in the amount of the payment that was taken. On the Invoice, the Visit Balance will also show a credit. As items are added to the Invoice, the Visit balance will change.
🛑 Made a mistake on the Invoice and need to fix it? Visit our Refunds and Returns Guide for more information!