Concepts/Charge Item: Difference between revisions

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conceptbillingCARE 3.0+

Definition

A charge item in Care records one billable service or item against a patient's account. A consultation, a procedure, or a dispensed medicine is each a charge item. Charge items are the building blocks that Care bundles into invoices.

You do not open charge items on their own. Charge items always appear inside an appointment, a service request, or the Charge Items tab of an account.

Key Attributes

Components	What it captures
Title	The name of the charge. You must enter a title.
Description	More detail about the charge. This is optional.
Quantity	How many units of the service or item the patient receives. You must enter a quantity.
Price Components	The base price and any surcharge, discount, tax, or informational amount. You must enter at least one price component.
Note	A free-text note about the charge. This is optional.
Status	The current state of the charge item. See [[#status	Status]].
Charge Item Definition	The pre-configured and priced item or service that the charge item comes from, if any.
Performer	The person who performed the billed service. This is optional.
Source record	The clinical record that the charge comes from, where relevant. This is a service request, a medication dispense, an appointment, or a bed association.

Account and Encounter

Every charge item belongs to exactly one account. A charge item is optionally linked to one encounter.

You can move a charge item from one account to another account while its status is Billable.

Status

Status	Description
Billable	The charge item is ready for an invoice. This is the starting status.
Not Billable	The charge item does not go on an invoice.
Aborted	Someone stopped the charge item.
Entered in Error	Someone recorded the charge item by mistake.
Billed	Care sets this status when the charge item goes on an invoice.
Paid	Care sets this status when the invoice for the charge item is Balanced.

📝 Note

Not Billable, Aborted, and Entered in Error are the reasons that you choose when you cancel a Billable charge item. Care sets Billed and Paid for you as the invoice moves through its lifecycle.

Permissions

Care checks these permissions at the facility level.

Permission	What it allows	Roles
Can Create Charge Item	Add charge items to an account.	Facility Admin, Admin, Staff, Doctor, Nurse, Pharmacist
Can Update Charge Item	Edit a charge item and move charge items to another account.	Facility Admin, Admin
Can Read Charge Item	View and list charge items.	Facility Admin, Administrator, Admin, Staff, Doctor, Nurse, Volunteer, Pharmacist
Can Cancel Charge Item	Cancel a charge item.	Facility Admin, Admin

📝 Note

Care lets you edit or cancel a charge item only while its status is Billable.

Pages that link here:

Concept: Concepts/Invoice
Reference: References/Charge Item

@@ Line 9: / Line 9: @@
 }}
+== Definition ==
-A '''charge item''' is a single billable line for one service or product given to a patient — a consultation fee, a lab test, a dispensed medicine, a bed-day. It is the atom of billing in Care: the smallest unit that records ''what was charged, how much, and why'', before anything is grouped onto an invoice.
+A '''[https://build.fhir.org/chargeitem.html charge item]''' in Care records one billable service or item against a patient's account. A consultation, a procedure, or a dispensed medicine is each a charge item. Charge items are the building blocks that Care bundles into invoices.
-== What it represents ==
+You do not open charge items on their own. Charge items always appear inside an appointment, a service request, or the Charge Items tab of an account.
-In Care's FHIR-aligned model, a charge item maps to the '''ChargeItem''' resource. Each one ties four things together:
+== Key Attributes ==
-* '''What''' — the service or product, named by a title and an optional billing code
-* '''How much''' — the quantity and a full price breakdown that resolves to a total
-* '''Why''' — the activity that produced it, such as a service request, a dispensed medication, an appointment, or a bed stay, and who performed it
-* '''Where''' — the patient and the account it sits on, and optionally the encounter it relates to
+{| class="wikitable"
-The key idea is that a charge item is ''self-contained'': it carries its own pricing rather than looking up a live rate, so the cost is locked at the moment of charging and never drifts when the catalogue changes later. And a charge item is not an invoice. Charges accumulate on an account as care happens; an [[Concepts/Invoice|invoice]] is the separate, later act of selecting some of them and presenting them for payment.
+! Components !! What it captures
+|-
+| Title || The name of the charge. You must enter a title.
+|-
+| Description || More detail about the charge. This is optional.
+|-
+| Quantity || How many units of the service or item the patient receives. You must enter a quantity.
+|-
+| Price Components || The base price and any surcharge, discount, tax, or informational amount. You must enter at least one price component.
+|-
+| Note || A free-text note about the charge. This is optional.
+|-
+| Status || The current state of the charge item. See [[#status || Status]].
+|-
+| Charge Item Definition || The pre-configured and priced item or service that the charge item comes from, if any.
+|-
+| Performer || The person who performed the billed service. This is optional.
+|-
+| Source record || The clinical record that the charge comes from, where relevant. This is a service request, a medication dispense, an appointment, or a bed association.
+|}
-== How it connects ==
+=== Account and Encounter ===
-A charge item never floats on its own — it always points back at the records around it:
+Every charge item belongs to exactly one account. A charge item is optionally linked to one encounter.
-* '''Account''' — every charge item lives on exactly one [[Concepts/Account|account]], the running ledger for a patient. Omit the account and it lands on the patient's default one.
+You can move a charge item from one account to another account while its status is Billable.
-* '''Patient''' — the person being billed. Charge against an [[Concepts/Encounter|encounter]] and the patient is inherited from it automatically.
-* '''Encounter''' — the visit or admission the charge relates to. Optional: charges can also exist outside any single encounter.
-* '''Charge item definition''' — an optional template. Applying a [[Concepts/Charge Item Definition|charge item definition]] builds a fully-priced charge item from the facility's catalogue, so staff never re-key prices by hand.
-* '''Invoice''' — once a charge is billed and settled, it links back to the [[Concepts/Invoice|invoice]] that paid it.
-== Pricing model ==
+=== Status ===
+{| class="wikitable"
-Price is never a single number. A charge item holds a list of '''monetary components''' that stack up to the total: a '''base''' per-unit price (exactly one, multiplied by quantity), '''surcharges''' added on top, '''discounts''' subtracted (optionally capped by a discount rule), and '''tax''' applied to what remains. A component can also be marked '''informational''' — shown for reference but excluded from the total.
+! Status !! Description
+|-
+| Billable || The charge item is ready for an invoice. This is the starting status.
+|-
+| Not Billable || The charge item does not go on an invoice.
+|-
+| Aborted || Someone stopped the charge item.
+|-
+| Entered in Error || Someone recorded the charge item by mistake.
+|-
+| Billed || Care sets this status when the charge item goes on an invoice.
+|-
+| Paid || Care sets this status when the invoice for the charge item is Balanced.
+|}
+{{Note|1=Not Billable, Aborted, and Entered in Error are the reasons that you choose when you cancel a Billable charge item. Care sets Billed and Paid for you as the invoice moves through its lifecycle.}}
-Care recomputes this breakdown on the server every time a charge is created or edited; clients never set the total themselves. When a price departs from the catalogue rate, an override reason can be recorded alongside it.
-== Lifecycle ==
-A charge item moves through billing states as it is priced, invoiced, and settled:
-<syntaxhighlight lang="text">billable → billed → paid</syntaxhighlight>
-* '''billable''' — priced and ready to be placed on an invoice
-* '''billed''' — included on an invoice (set by the platform, not by hand)
-* '''paid''' — settled, with a link to the invoice and the date it cleared (also platform-set)
-Off to the side, a charge can instead be cancelled — recorded but never billed (<code>not_billable</code>), called off before billing (<code>aborted</code>), or withdrawn as a mistake (<code>entered_in_error</code>). Cancelling a charge that was sitting on a draft invoice pulls it off and rebalances that invoice; a charge already on a finalised invoice cannot be cancelled at all. The <code>billed</code> and <code>paid</code> states are never set manually — they only ever reflect what billing has actually done. Cancellation is free for a short window after creation; after that it requires an explicit permission.
 == Permissions ==
-Access to charge items is governed by facility-scoped permissions.
+Care checks these permissions at the facility level.
 {| class="wikitable"
+! Permission !! What it allows !! Roles
 |-
+| Can Create Charge Item || Add charge items to an account. || Facility Admin, Admin, Staff, Doctor, Nurse, Pharmacist
-! Permission
-! Description
-! System Roles
 |-
+| Can Update Charge Item || Edit a charge item and move charge items to another account. || Facility Admin, Admin
-| <code>can_create_charge_item</code>
-| Create a charge item, apply charge item definitions, and move charge items between accounts
-| Facility Admin, Admin, Staff, Doctor, Nurse, Pharmacist
 |-
+| Can Read Charge Item || View and list charge items. || Facility Admin, Administrator, Admin, Staff, Doctor, Nurse, Volunteer, Pharmacist
-| <code>can_create_negative_charge_item</code>
-| Allow charge items priced below zero (reversals/credits) when applying definitions
-| Facility Admin, Admin
 |-
+| Can Cancel Charge Item || Cancel a charge item. || Facility Admin, Admin
-| <code>can_read_charge_item</code>
-| View charge items and their pricing
-| Facility Admin, Administrator, Admin, Staff, Doctor, Nurse, Volunteer, Pharmacist
-|-
-| <code>can_update_charge_item</code>
-| Edit an existing charge item
-| Facility Admin, Admin
-|-
-| <code>can_cancel_charge_item</code>
-| Cancel a charge item after the free-cancel window has elapsed
-| Facility Admin, Admin
 |}
+{{Note|1=Care lets you edit or cancel a charge item only while its status is Billable.}}
-Roles are granted to users through facility and organization memberships, and permissions cascade down the organization tree — a role held higher up applies to the facilities and patients beneath it.
 {{Navbox billing}}
 {{Related}}
-Wiki: ohcnwiki.tellmey.fyi