The Transaction Ledger in ChiroHD provides a detailed, line-by-line view of all financial activity associated with a patient’s case. This includes services rendered, payments posted, insurance activity, write-offs, and patient balances. The ledger is organized per case, ensuring that financial data remains clean and case-specific.
Accessing the Transaction Ledger
There are three primary ways to access the transaction ledger:
1. Click the Transaction History icon in the Patient Snapshot.
2. Click the Overview of Transactions shortcut in the Patient Snapshot.
3. Navigate to the Transactions tab in the Patient Profile.
Navigating the Ledger Interface
Each patient case has its own transaction ledger. Use the dropdown menu at the top of the screen to toggle between active cases (e.g., Insurance, Personal Injury, Cash, Medicare).
You may also:
Use the Items Per Page selector to control how many entries display at once.
Toggle through additional pages using the navigation arrows at the bottom of the ledger.
Ledger Tools and Functions
1. Move Transactions
To reassign a service or payment to a different case:
Click Move Transactions to Another Case.
Select the appropriate destination case and confirm the change.
This option will only show if there are two or more cases on the patient's profile.
2. Show/Hide Options
Show Billing Info: Expands columns to display insurance-specific data, including:
Primary Paid
Secondary Paid
Write-Off
Dropped
Show Audit Info: Displays timestamps and user activity for every item (created or edited).
Show Void Items: Displays previously voided items in red.
Use the Undo button to reverse a void if necessary.
3. Color Legend
Each transaction line is color-coded:
Purple: Service has not yet been billed (or specifically, the claim has not yet been created).
Yellow: Claim has been created for this service.
Blue: Service is partially paid—insurance balance remains.
Green: Service is fully paid and settled.
Note: Paid status may mean the insurance paid $0 on this service and the remainder when to patient responsibility. This simply means the service has been fully settled by the insurance through the Process EOB screen.
4. Editing and Voiding Transactions
Group-Level Actions:
If there are a group of services performed on the same date of service and entered at the same time, they will be grouped together.
Edit Group: Click the Edit icon on the left to modify all charges entered as part of the same transaction group.
Void Group: Click the Group Void icon to void an entire batch of charges.
Line Item-Level Actions:
Edit Line Item:
Click the Edit icon under the "Billed" column to:
Modify billed amount
Update patient responsibility fields (deductible, co-pay, co-insurance, other patient responsibility)
NOTE: Primary Paid and Secondary Paid are the only fields that are not editable directly on this patient ledger. These payments would need to be entered in the Process EOB screen in the Insurance Dashboard.
Click the Green checkmark under the "Billed" column to save the edits.
Void Single Item: Click the Void icon next to a specific line to void only that service or payment.
5. Switching Financial Responsibility
You can change the responsible party for a service from insurance to the patient or vice versa. This will update the allocation and affect how balances are displayed and reported.
Click the Responsibility icon next to the service line.
Confirm the switch.
6. Ledger Columns Overview
Column | Description |
Service Date | Date of the service |
Description | Name and code of the billed service |
Billed Amount | Original billed charge |
Patient Total | Sum of patient-responsible fields: deductible, co-pay, co-insurance, other |
Primary / Secondary Paid | Payments received from insurance |
Write-Off / Dropped | Adjustments not expected to be paid |
Insurance Balance | Outstanding amount due from insurance |
Patient Balance | Remaining balance due from the patient |
At the top right of the ledger, you will see a running balance for the case, calculated from all transactions listed from bottom to top. The topmost value represents the current outstanding balance.
Summary
The Transaction Ledger in ChiroHD is your central tool for financial transparency and billing accuracy. It supports:
Line-by-line tracking of services and payments
Case-specific management of financial data
Complete auditability of all user actions
Manual adjustments, voiding, and reassignment of responsibility
Best Practices:
Regularly audit the ledger for accuracy
Use filters to manage visibility (e.g., voided or billed items)
Confirm case associations before adding new charges
Always verify payment and write-off data before finalizing claims
For assistance with ledger corrections, insurance adjustments, or transaction disputes, contact ChiroHD support.