Default services, special prices, and monthly charges can all be set up under patient cases to post automatically to the patient's ledger.
Where to Set Up or Edit Default Charges:
1. Default charges can be set up under the Patient's Case.
Navigate to the Patient's Profile < Cases Tab < Defaults/Patient Rates/Recurring Charges.
2. Default charges can be set up via the SOAP Notes screen in two different places.
Pull up a Patient on the soap notes screen. Click on the Charges to edit the charges/services for the day.
Or by clicking on the charges in the bottom left-hand corner (like seen below).
When the charges are entered and the SOAP note is complete, Select"Yes" when prompted if you want to save today's charges 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.
For an example: Each time this patient comes in for an adjustment, their "Every Visit" defaults will be automatically posted to their ledger.
Reminder: Payments for this service still need to be taken at checkout. This does not collect payments, but posts the charge on the ledger.
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.
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.
Reminder: Discounts can only be added to services on a cash case using default services. Discounts on Insurance Cases, can be applied using the fee schedule.
3. Monthly Charges
Monthly charges are used to post a particular service every month on a specified day.
Example: 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 monthly membership charge will show as a CHARGE and the payment will show as a CREDIT, thus balancing the patient's ledger.
Please see other resources on setting up monthly charges.
Default Services Settings
Service/Inventory Item: The name of the service or inventory item that was added.
Charge Amount: 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. This amount is the amount of discount, not the total price including discount.
Write-off Reason: The category or reason for providing the write-off.
NOTE: These Write off categories provided are not editable at this time.
Units: Number of units that you wish you add to the service. For insurance billing purposes.
DX Code Mapping: Can be used if you wish to set specific DX pointers on a service.
Modifiers: This is to be used if you need to apply a specific modifier onto a service
Charge Frequency: This is to indicate the type of default service (explained above).
Charge Day of Month: 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: 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 every time a monthly charge is added to a patient's ledger.
When Do Default Services Post Automatically?
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.
1. Default Services Are Set Up in Advance.
Default services must be added to the patient’s default case before the appointment.
2. Default Services Are Set to Every Visit Type.
3. Appointment is Scheduled on the Default Case.
Default services do not apply across multiple cases. The system will only reference the default case.
4. Appointment Is Scheduled on a Chiropractic Calendar
The appointment must be scheduled on a calendar with the provider type set to Chiropractor.
Appointments on non-chiropractic calendars will not post default services automatically. (Ie. non-chiropractic is massage therapist calendar)
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.
5. Appointment Is Marked as Arrived.
The appointment must be marked as Arrived on the day of the appointment.
6. SOAP Note Is Completed using the SOAP Note Screen.
If the SOAP note is put in using Patient Profile < Visits Tab, it will not automatically post.
7. SOAP Note Is Completed ON the Same Day as the appointment.
The provider must access a SOAP note screen on the day of the appointment.
SOAP notes completed on a later date will not trigger default charges.
8. SOAP Note Is Saved as a draft or Finalized.
Examples using Default Services
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:
Only the adjustment charge is set up as Every Visit as Jane would not receive the other services every time she came in.
I would not add the VIP monthly charge until it is that time in her care plan, but wanted to provide a visual.
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.