How to Create an Invoice for First-Visits

How to Create an Invoice for First-Visits

zHealthEHR allows an easy way to create an invoice for patients visiting for the first time to your practice. Multiple providers under the same account who wish to create an invoice must be assigned the system administrator role to create an invoice.

1. Login to your zHealth Account
Login to the zHealthEHR account using your username and password.

2. Search for the patient
To create an invoice for a particular patient visit, search for the patient's name. Enter the first name or last name of the patient in the top navigation bar search box. Click Enter.

3. Locate and click on the patient's name from the Patient Search Results for which you want to create an invoice. The patient's Chart page opens.

4. Locating the Invoice Tab
a. Hover over the SOAP Note tab and click on it. The SOAP Note page opens.

4b. On the left side of the SOAP Note tab, browse through the options and click on the ‘Invoice’ option.

5. The Invoice window will open. The Invoice page consists of the  Diagnosis code, CPT code, Supplement Code, and Misc Items.

6. Add Diagnosis Codes
a. Under the Diagnosis section, just enter the first few letters of the diagnosis description and the system will auto-populate all results. For instance, just type 's' or ‘sub’ for subluxation and our software will auto-generate all ICD-10 codes for different subluxations. 
Note: Any 'inactive' ICD-10 codes (for example: M54.5) will be shown in red in color and have "| inactive" written after the code.
Tip: Set up diagnosis code favorites to manage code entry when creating a new invoice.
6b. Select the code relevant to the patient’s condition and then click ‘ Add ’ to enter the code.
6c. To add more diagnosis procedures, repeat the above step as necessary.
6d. Once all diagnosis codes have been added, review the Diagnosis section and make any necessary changes.

Selecting the most specific codes relevant to the patient’s diagnosis and putting them in the right order is crucial for correct invoice creation. When you report additional diagnosis codes, you need to determine their proper order and rearrange the list of ICD-10 codes accordingly. To reorder the procedure lines in the list:

6e. Click the ‘
Four Arrows’ icon and drag the procedure code up and down as needed.

6f. To remove a procedure code, click the ‘
Delete’ icon.

7. Add CPT Code
a. Under the CPT Code section, just enter the first few letters or numbers of any CPT code and the system will auto-populate the results for you. Select the right CPT code relevant to the service rendered to the patient and click the ‘
+ ’ icon to enter the code. Then hit the ‘ Save ’ icon.
Tip: Set up CPT code favorites to manage code entry when creating a new invoice.

7b. Enter DOS from, DOS to, POS, Units, *UOM, Diagnosis Pointer, and Charges .

7c. To add more
CPT codes for the given patient visit, repeat the above two steps as necessary.

7d. Once all CPT codes have been added, review the CPT Code section and make any necessary changes.
*Note: UOM means Units of Measure and Codes. UOM defines how much and in what unit the quantity is expected. zHealth lists the following UOMs:
UN = Unit
F2 = International Unit
MJ = Minutes

7e. To remove a CPT code, click the ‘ Delete ’ icon.

8. If you sell any supplements to patients, you can charge them and add the charges to the invoice. Click here to find out  how to add a supplement code to the invoice .

9. Add Misc Items
a. Providers selling additional supplies or non-billable services can add items/services under the Misc Items section.

10. Enter Invoice Payments
At the bottom of the page, you will find the Invoice Payments option.
a. Enter the
Amount Paid by the patient. 
b. Adjustment Amount, Paid By, and Date Paid will be automatically populated once you enter the paid amount. For Date Paid, by default, the system takes the current date. Change it if required.
c. From the drop-down menu, click to select Payment Type, such as Cash, Check, Gift Card, zHealth Pay, etc.
d. In case of Gift Card Payment or Check Payment, you can enter any Note related to the Gift Card or Check Number.
e. Click "Add" to add the payment to the Invoice.

*Note: If the patient co-pay has been paid via zHealthPay, you will be able to see the Payment Type as ZH-PAY along with the Transaction ID in brackets. You can look up this Transaction ID using the zHealthPay Advanced Transaction Search Report to get more details about the transaction made, such as transaction date, funding date, name and last 4 digits of the person for this transaction.

**Note: Our system will show a warning message - "You are attempting to apply for a payment that exceeds the balance of this invoice. Any amount greater than the balance will be applied to the patients credit. Would you like to continue?" - if you try add payment to the invoice that has no CPT codes in it. Check the second image on the right side for your reference.

11. If you select 'Paid By' as Insurance in the invoice payment, our system will show an alert (as a pop-up window) to make sure if you want to use insurance for the payment rather than using EOB/ERA interface to post payment.
a. If you click "
Yes", the system will add the amount paid and adjustment under the name of the insurance in the Invoice Payment section.
b. If you click "
No", the pop-up window will close and you can continue to add the amount paid by the patient in the Invoice Payment section.

12. Change Dates

Before you learn how to make changes to the dates in the invoice tab, you need to know what are the different dates mentioned in our invoice. This is important as the Health Insurance Claim Form (HCFA) requires billers to provide the Date(s) of Service. 




Date of Injury

This is the exact date when the injury, incident or exposure happened with the patient.

Initial Treatment Date

This is populated once the first CPT code (charge) is added to an invoice. Once the initial treatment date has been entered (or first CPT code filled out), it SALTs over each time from there.

Acute Manifestation Date

 Acute Manifestation Date is required when CPT code is 98940, 98941, 98942, 98943, and CR2-08 (HCFA Box 10d) is "A" or "M" (RC183).

Accident Date

This is the exact date when the accident happened with the patient. This date is required in HCFA Box 15 (with qualifier 439) or the Additional Fields section when HCFA Box 10b is marked as ‘Yes'.


Now let’s see how to make changes to the dates section while creating an invoice for first-visits.

12. Make Changes to Dates

a. On the left side of the invoice window, you will see
Comments, Dates, Invoice Summary, and Invoice Status.
b. In the
Comments section, add any comment for the provider, staff, or biller.
c. Change the
 Visit Date if necessary.

12d. When a new patient comes in, the initial treatment date on the invoice will be blank. It will populate with the Date of the CPT Code or DOS (Date of Service).  The Initial Treatment Date SALTs over each time from there, but it needs to be checked/corrected if you are adding CPTs on a day other than the initial visit.

You can change the dates of injury, accident, or acute manifestation if necessary.

13. Click on Recalculate and Save.

14a. Click on the blue "Print"  button to print the Invoice if you need to send it for Paper Claim Submission. Or print the invoice if you need to give a copy to the patient.
b. Click "Email" to send the invoice to the patient's registered email address.

15. Keep the Invoice Status as ‘Open’ if you want to send the invoice for claim submission. You can choose ‘Closed’ status when the invoice claim has already been sent to the clearinghouse.

16. The patient’s invoice is now ready. You can submit the claim immediately after creating an invoice. Click the "Submit Claim" button on the left side of the screen.

17. Once the insurance payer sends an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of this claim, you can post the ERA or EOB right from the Invoice screen by:
a. Clicking the EOB button
b. Clicking the ERA button

    • Related Articles

    • How to Create an Invoice for Follow-up Visits

      zHealthEHR allows an easy way to create an invoice for patients visiting for follow-up visits to your practice. Multiple providers under the same account who wish to create an invoice must be assigned the system administrator role to create an ...
    • How to Delete a SOAP Note or Invoice

      Sometimes, you create a SOAP note for an appointment that just got cancelled. Sometimes, you create a SOAP note for the same patient visit twice by mistake. As a part of managing your practice's billing activities, it is important to find out and ...
    • Reviewing the Audit Trail of an Invoice

      It is possible to review the audit trail history of a patient's invoice. This information is read-only and for viewing purposes only. Here is how to view the audit trail for the invoice and what information you will find: 1. Access your zHealth ...
    • How to Print or Email Invoice to the Patient

      Through zHealth, you can quickly print or email invoice to your patient. This helps to streamline patient billing cycle and increase your patient collections as patients can view what they paid and what they need to pay you. Whether you print and ...
    • Warning Message for Missing Details

      Warning Message *Warning: Patient DOB/Address/Sex missing Warning Message Details This message will appear on the Invoice if the patient has missing date of birth, address, sex, and other details required for HCFA claim submission. Resolution Go to ...