Patient Ledger

  • Updated

The Patient Ledger is an accounting of a patient's insurance claims and Patient Billables organized by claim/billable so you can easily analyze a patient's total financial history without running multiple reports.

The Patient Ledger includes Collections Totals and Aging Summary for all Treatment Episodes, Insurance Claims, and Patient Billables - so you can quickly calculate outstanding balances and review receivables performance at the patient level. 

Viewing the Patient Ledger

From the Patient record, click on the Patient Ledger tab.mceclip0.png

The Patient Ledger is organized into four sections:

  • Insurance Payments: Lists each treatment episode with the individual claim and payment details.
  • Patient Payments: View patient billables and payments (only available with the Patient Billing add-on).
  • Totals: A table containing collection totals for all treatment episodes.
  • Aging: A table of insurance and patient aging balances. 

Insurance Payments

The Insurance Payments portion of the Patient Ledger is organized by Treatment Episode, with the most recent Treatment Episode listed first. 


  1. To view the ledger details for the individual treatment episode, click on the arrow next to the primary diagnosis. mceclip3.png
  2. Each Insurance Claim is listed by claim submission date (listed date ascending); click the arrow next to the claim submission Date to see the services billed on the claim.mceclip4.png
  3. Once a Payment has been matched to a claim, the payment will appear as its own row in the ledger along with payment details: Adjustments (Ins Adjusted), Deductible (Ded), Co-insurance (Co-ins), Co-pay, Paid to Patient, Additional Patient Responsibility (Addl PR) and Insurance Paid (Ins Paid). Click the arrow next to the Payment to view the payment details by payment line item.mceclip6.png
  4. The Totals row at the end of the ledger totals up all charges, payments, and adjustments. The Balance column will increase as new claims are billed and decrease as payments are received and posted. mceclip7.png

Patient Payments

The Patients Payments section is only visible to organizations using the Patient Billing add-on to bill patient responsibility and manage private pay billing. This section contains rows for each patient Billable, Applied Payment, and recorded Adjustment, with the oldest transaction listed first.


  1. For each row, you can view the Charges, Provider Adjustments (Provider Adjusted), Patient Payments, and the running Balance.mceclip9.png
  2. Click the arrow next to the billable approval Date to review the line items. mceclip10.png
  3. The Totals row at the end of the table totals up each column. Charges will increase the balance and adjustments and patient payments will decrease the balance. A negative balance indicates the patient has paid more than they currently owe. mceclip11.png


The Totals section summarizes the financial details across all Treatment Episodes. 


Collection Totals

The Collections Totals will show:


  • Total Charged: Sum of all services charged on all claims for the patient.
  • Total Paid (Ins): Sum of all payments received and matched to claims for that patient.
  • Total Paid (Patient): Sum of all payments received by the patient (included with the Patient Billing module only).
  • Patient Balance: The sum of all billables, payments, and adjustments to date
  • Unapplied Payments: The sum of all unapplied payments recorded with the Patient Billing module. 


The Aging will show the current unpaid balances by Insurance (Open claims with an unpaid balance) and by Patient (Open billables with an unpaid balance). 


Patient Responsibility Balance

The Patient Responsibility Balance will show the Good Faith Estimate in comparison to the overall Total Patient Payments collected to determine the Good Faith Estimate Balance.

Export Ledger

You can export the Patient Ledger to an Excel file by clicking the Download to Excel button. This will automatically include all treatment episodes.



Are there report tie-outs for the Patient Ledger?

There are no specific reports meant to tie out to the Patient Ledger because it was designed to replace the need to use a report to get claim and billing financial information at the patient level. However, transactions included in the ledger should tie out to those same transactions in AveaOffice reports. For example, a payment listed in the Insurance section should match that same transaction details in the Claim Payments Detail report. 

How can I get the Patient Billing features mentioned in this article? 

Please contact the Support team for more information.   

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