Ledger

The Ledger is the patient's account history — every charge, payment, adjustment and credit, for whatever period you ask for. Use it to answer "what happened on this account?", to review a date range before billing, or to check a balance a patient is querying.

Unlike Transactions, the Ledger is for looking, not entering.

Choosing what to show

Opening the Ledger presents a Find Transaction dialog first. Rather than dumping the whole account history at you, it asks what you want to see.

Setting	What it controls
Provider	Limit to one provider, or leave it across all
SmartDate	The date range — defaults to roughly the last month
By	What to order on, typically Date Of Service
Direction	Ascending or descending

Tick Use current SmartDate as Default to keep your preferred range for next time.

Categories

The category grid decides which kinds of entry appear, split by whether they sit on the Patient or the Insurance side of the account:

Category	Covers
Service	Charges for services and products
CoPay	Per-visit patient amounts
Insurance Refused	Amounts the carrier declined
Other Charges	Charges outside the normal service list
Payments	Money received
Other Credits	Credits and adjustments

The buttons beside the grid set common combinations quickly:

All · None · Services · Patient · Insurance · Accounting

Click Display to run it.

Narrow the categories to answer a specific question

Chasing a patient balance? Patient plus Payments and CoPay gets you there without insurance traffic in the way. Reconciling a carrier? Insurance does the reverse. The default of everything-on is fine for a general look but noisy for a specific one.

Reading the account

Balances are split three ways throughout ChiroPad, and the Ledger is where the split becomes visible:

• Patient balance — what the patient owes
• Insurance balance — what carriers owe
• Total — the two combined

A balance shown in parentheses is a credit.

Two different write-offs can both be in play

A balance may have been reduced twice by different mechanisms. A contractual write-off is applied automatically when the claim is created, for the difference between your fee and the carrier's allowable amount. A transfer/write-off split is applied later, when the payment is posted, to whatever the carrier did not pay. If a balance looks wrong, check which of the two you are actually looking at.

Statements

The patient's Statement setting on the Financial tab decides whether they receive one at all — Always, Never, or only when there is an Amount Due.

Never bill a Medicaid patient

Set Statement to Never and Late Notice to None for Medicaid patients. Billing a patient under Medicaid is unlawful, and these settings are what protect you.

Where a patient is a dependant of a Head of Household, their charges roll up onto the head of household's statement, itemised per family member, rather than generating a separate one.

Late charges

Late charges and interest are configured per patient, but only actually post if the practice-level setting that creates them is switched on.

Late fees require documented advance notice

Federal regulations require that a patient is told in advance that late fees or interest may be charged — and that you can prove they were told. If you do not have signed acknowledgement on file, do not charge them.