Instinct EMR is always working on capturing charges for you, so invoicing your clients is simple and effortless. This article will explain how it works as well as other tips and tricks to make your workflow as productive as possible!
Table of Contents
✔ Completing A Treatment Order
Most invoice items are generated by completing a treatment order. It is important to note, that even though the items are shown on the actual Tx Sheet, they are not actually sent to the invoice until they are completed.
Here are a few examples of items that Instinct will capture charges for:
Blood pressure can be scheduled to be completed twice daily.

Once the treatment is completed on the Tx sheet, the cost of the service goes to the Instinct Invoice.

A single Cerenia injection is ordered to be completed on the Tx Sheet as seen below.

Once completed, the cost of the medication will go directly to the Instinct Invoice.

🤖 Automatic Charges
Instinct has the ability to charge for specific service items ‘automatically’.
Hospitalization Charges
A common example of this would be hospitalization charges. When a hospitalization level is chosen on the Tx sheet (drop-down menu), the hospitalization fee will start to charge at that time and the fee will go to the Instinct Invoice.
💡 ProTip: Click here to read more about Common Hospitalization Workflows!



The charge will continue to go to the Instinct Invoice at a specific frequency we set up behind the scenes (every 2 hours, 12 hours, every 24 hours, etc). If the hospitalization level is changed, the original will stop charging and the new one will start to charge.
💡 ProTip: Check out our Careville article for a full description of Automatic Charges!
Other Automatic Charge Examples
Instinct has the ability to ‘link’ Automatic Charges to products and services, so one order can generate a handful of automatic charges to go to the Instinct Invoice at the time the first treatment is due.
Example: IV Fluid – LRS is ordered on the treatment sheet and several charges can be linked to that order:
- IV Fluid Pump
- IV Fluid Monitoring
- Extension set/admin set

The items associated with the IV Fluids – LRS treatment will now show on the invoice at the time to order is first due on the treatment sheet:

Transfusion – pRBC is ordered on the treatment sheet
- Transfusion set up fee
- Transfusion monitoring charge
- Unit of pRBC

Just as with the IV Fluids, the items associated with the Transfusion treatment will now show on the invoice at the time to order is first due on the treatment sheet:

💊 Vial Charging
Medications can be charged ‘per vial’, ‘per bottle’, or ‘per bag’ and can be set up to only charge one time on the Instinct Invoice.
First, be sure that the individual automatic charges are properly set up for the particular medication.

Once in the product information area, select the Automatic Charges Add/Edit Charges icon.

Add the automatic charge associated with the product with a frequency of ‘Once’.

When the product is ordered on the Tx sheet, the cost of the vial will automatically go to the Instinct Invoice one time.

When medication is ordered on the Tx Sheet, it can be ordered “per mL”, as seen above in the blue box, but the invoice will show the quantity as “1” vial.

The order can continue to be completed, and will not generate further fees.
1️⃣ One-Off
From anywhere in the Patient Visit screen, you have the option to use the +One Off button in the upper right-hand corner to quickly add treatments and products.

When the One-Off feature is used, if there is a fee associated with the order, that fee will automatically go to the Instinct Invoice.

➕ Adding to the Invoice
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 each other).
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:
First, head to the Invoice screen and search for any Invoice Product Group you’d like to use.

💡 ProTip: Another helpful Careville article, EMR Product Groups gives examples that can be modified into Invoice Groups. Creating separate Invoice Groups can be 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.
Next, 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.

Finally, 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:

💊 RX Charging
While entering patient prescriptions, items being added will drop right onto the invoice in real-time with information such as a timestamp, quantity, prescribing doctor, and price.
Simply head over to the RX icon at the top right-hand corner of any Patient Visit screen.

From there, you can enter the information for the products to be dispensed. You will want to be sure to fill out all of the information that has an asterisk to proceed. Next, click Prescribe button and this will send the item directly to the invoice, as seen below.

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