The Instinct Invoice is a valuable audit tool to ensure a complete list of charges are being captured and entered in your practice software.
Table of Contents
Connected Practices:
Connected practices have an integration with your PIMS (Practice Information Management System) allowing Instinct to sync and download items from your PIMS invoice to the Instinct invoice.
- Missed Charges – Instinct will automatically “flag” items with an orange triangle that are missing or not yet entered on your PIMS invoice. To hide any synced/downloaded charges and only show missed charges, toggle the “Only Show Missed Charges” button.
Missed charges can be handled two ways:
- Void it if it was incorrect, or
- Add this item to your main practice software invoice which will cause it to “sync” (more on this below)
- If you enter a flagged item on your PIMS invoice with the same code and quantity, within 30 seconds, the flag will change to a sync icon.
Depending on your clinic and 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.
💡 ProTip: connected practices can still 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 the Instinct invoice with a download icon.
Troubleshooting and ProTips
- Make sure you enter the code and quantity exactly as they appear on Instinct.
- Do not change the quantity of any synced items on your practice management software invoice. If changed, Instinct will update the item as a missed charge on the Instinct Invoice (and potentially send to the PVL again if you are a Cornerstone practice).
- If using an Omnicell or Cubex drug cabinet, please make sure the quantity matches in Instinct. For example, if the Instinct order says 0.62mls and you remove it from a drug cart as 0.6mls, the charges will not sync in Instinct.
- Make sure the Dr. initials exist in your practice management software and match in Instinct.
Unconnected Practices
If your clinic does not have your practice management system integrated with Instinct, simply use the invoice as a checklist as you enter charges on your main software invoice. Once entered, click the missed charge icon (orange triangle) so it is “checked off”.
If an item does not belong on this invoice, simply click the 3-dot menu next to the item and select “Void”. You can always “Undo Void” by clicking the 3-dot menu again if needed.
Practical Workflow for Using Missed Charges
- Treatment orders are scheduled/performed by you and your team.
- The patient invoice is automatically forming in Instinct so you know what needs to be charged and when it was completed.
- As charges accumulate, most end up as a “missed charge” which is documented with an orange triangle.
- A team member will check for these missed charges and add them to your practice management invoice. Based on your billing audit workflow, we typically recommend adding these charges to your practice management invoice 1-2 times a day. In addition, a treatment order can be scheduled on Instinct as a friendly reminder to perform this step (labeled as “Audit/Invoice Charges”, for example). If you need some guidance with this step, feel free to visit our Charge Auditor’s Guidelines.
- Checkout: This step is CRUCIAL! Have your front desk check for any missed charges at the time of discharge BEFORE calling the client to the front desk. If none exist – you’ll see a piggy bank on the Instinct invoice (see below) and you’re good to go! If missed charges exist, have your front desk call the medical team or financial team based on your workflow to fix before checking out.
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