Connected Practices Only: In order for charges to “Sync”, the code (item ID) and quantity in Instinct must match in your main practice software
Manually Entering Items in your main practice software
Instinct will automatically “flag” items that are missing or not yet entered on your practice system invoice. If you enter a flagged item on your main practice system invoice with the same code and quantity within 30 seconds, the flag will change to a sync icon:

Important Note – Please make sure you enter the code and quantity exactly as they appear on Instinct, otherwise, items will not sync properly.
Using the “Send Missed Charges” button
If available for your hospital based on integration capabilities, you may also see an orange “Send Missed Charges” button at the bottom of the invoice. When clicked, this sends all missed charges from Instinct to your practice management system so you do not have to manually enter them in your PIMS as described above.

Important Note – If you receive an error after clicking “Send Missed Charges”, please make sure this product exists in your PIMS, the code matches and the provider initials exist in your main practice system (all case sensitive).
A few things to keep in mind:
- Use the “Only Show Missed Charges” button located at the top right hand corner of the screen to quickly identify which charges are missing. This is also great for use at the front desk prior to checking a patient out to ensure last-minute items don’t get missed.
- You can always enter charges directly on your main practice software that may not be in Instinct (such as a TPLO plate). That item will be brought into Instinct to keep predicted billing accurate and a download icon will show.
- If an item does not belong on this invoice, simply click the 3-dot menu next to the item and select “Void”. This hides the charge and you can always “Undo Void” by clicking the 3-dot menu again if needed.