Default services, special prices, and monthly charges can all be set up under patient cases to post automatically to the patient's ledger.
Where Do I Set Up Default Charges?
1. Default charges are set up under the patient's case. Navigate to the patient's case > Defaults/Patient Rates/Recurring Charges.
2. Default charges can also be set up via the SOAP Notes screen by selecting "Yes" when prompted if you want to save as default.
Types of Default Services
1. Every Visit
Every visit default services are designed to post to the patient's ledger upon completion of their visit.
As an example, this means that each time this patient comes in for an adjustment, their "Every Visit" defaults will be automatically posted to their ledger.
Payments for this service still need to be taken at checkout.
These default services will only post if the Doctor pulls up the patient's appointment on the SOAP note screen, and either Submits a SOAP Note or Save As Draft, on the same day as the appointment.
These default services will appear on the SOAP notes screen in the "Charges" box, or at the bottom left-hand corner.
"Every Visit" defaults can be updated from the SOAP note screen. When the Doctor chooses new services from the SOAP note screen, they will receive a prompt which asks whether these should be saved as the new services. If the doctor chooses "yes," services will be updated in the patient case, and if "no," the charges will be posted for that visit only, and future visits will use "Every Visit" defaults.
Every visit charges will only automatically post to the appointment on a Chiro calendar.
2. Time of Purchase
Time of Purchase services should be used when the patient receives a discounted rate on a service, but it is not a service that they receive every time they come in (that would be an Every Visit default service).
The purpose is to notate/automate in the patient's case discounts they may receive on services or inventory items.
Since Time of Purchase services do not occur at every visit, these services will have to be manually added via the transaction modal or the SOAP notes screen.
Whenever a Time of Purchase service is manually added, it will pull the discounted rate and settings that were established under the defaults tab.
This can help with ledger accuracy if a patient's care plan dictates that they receive certain discounts on services or inventory items.
That way a staff member does not have to remember every discount, it can already be accounted for in the patient's case.
Discounts can only be added to services on a cash case, you cannot discount insurance services.
3. Monthly Charges
Monthly charges are used to post a particular service every month on a specified day.
If a clinic utilizes a monthly membership/charge structure, they can set up a monthly membership CHARGE to post on the same day as their monthly payment. This way, the payment will show as a CREDIT, and the monthly membership charge will show as a CHARGE, thus balancing the patient's ledger.
NOTE: Before choosing to use the Monthly Charge option, please watch this video to see if monthly charges is the desired setup for your office: Watch Now
Let's use all three types of default services in an example!
Jane Doe signed up for a care plan that includes 30 adjustments, then a VIP monthly membership for 6 months, 12 massages, a ChiroFlow Pillow, and a bottle of Super Omegas. Jane decides to pay for her care plan in a monthly installment (paying on the 15th of the month), so the office gives her a 15% discount on the entire care plan. Here is how I would set up her default services -
I would not add the VIP monthly charge until it is that time in her care plan, but wanted to provide a visual.
As you can see, only the adjustment charge is the only one set to Every Visit as Jane would not receive the other services every time she came in.
Understanding The Fields On Default Services
Service/Inventory Item - this will display the name of the service or inventory item that was added.
Charge Amount - this will display the default price of the service or inventory item. DO NOT CHANGE THIS AMOUNT.
If you want to provide the patient a discount, this needs to be done by using the write-off field.
If you just change the Charge Amount, this can come across as a dual fee schedule. Versus keeping the charge amount the same across the board for all patients, but utilize the write-off field to provide a discount.
Write-off Amount - this will apply an in-line write off to that single service or inventory item. Inset the amount of money you wish to take off of the charge amount, not the total value of the item that you want to end up at.
Write-off Reason - this would be the category or reason for providing the write-off.
The categories provided are not editable.
Units - this is the number of units that you wish you add to the service.
For insurance billing purposes.
DX Code Mapping - this is to be used if you wish to set specific DX pointers on a service.
For insurance billing purposes.
Modifiers - this is to be used if you need to apply a specific modifier onto a service
For insurance billing purposes.
Charge Frequency - this is to indicate the type of default service (explained above).
Charge Day of Month - this is to only be used when Monthly default service type is selected. It simply indicates which day of the month you want the system to add the charge to the patient's ledger.
Charges Remaining - this is to only be used when Monthly default service type is selected. It simply indicates how many times that monthly charge needs to be added.
This will automatically reduce everytime a monthly charge is added to a patient's ledger.
How Default Services Work
Default services are designed to automatically post charges when specific conditions are met. To ensure charges post correctly, all requirements below must be followed. Any workflow outside of these steps will require charges to be added manually.
When Do Default Services Post Automatically?
Default services will only post automatically when all of the following conditions are met:
1. Default Services Are Set Up in Advance
Default services must be added to the patient’s default case before the appointment.
Default services do not apply across multiple cases. The system will only reference the default case.
2. Appointment Is on a Chiropractic Calendar
The appointment must be scheduled on a calendar with the provider type set to “Chiro.”
Appointments on non-chiropractic calendars will not post default services automatically.
Example:
If Red Light Therapy default charges are set up on the patient’s case, but the appointment is scheduled on a separate Red Light Therapy calendar tied to a non-Chiro provider, the charge will not post automatically and must be completed manually.
3. Appointment Is Marked as Arrived
The appointment must be marked as Arrived on the day of the appointment.
4. SOAP Note Is Completed the Same Day
The provider must access a SOAP note screen on the day of the appointment.
The SOAP note must be saved as a draft or finalized on the day of the visit.
SOAP notes completed on a later date will not trigger default charges.
What Is Not Supported
Default charges will not post automatically if:
The appointment is on a non-Chiro calendar
The SOAP note is completed after the appointment date
Charges are expected to apply to multiple cases
The workflow occurs outside the steps listed above
Any unsupported workflow will require manual charge entry.
Common Workflow Mistakes to Avoid
❌ Posting charges through the Visits tab
❌ Completing SOAP notes on a different day
(Saving a SOAP note as a draft on the same day is acceptable)
❌ Expecting default services to apply to more than one case
Key Takeaway
Default services are highly dependent on calendar type, provider type, timing, and documentation. Following the supported workflow ensures charges post automatically and reduces the need for manual corrections.