Creating a Patient Invoice for Lab and Imaging Orders

SigmaMD gives you flexible options to charge patients for lab and imaging orders. Depending on your billing settings, charges can be added automatically to a draft invoice or manually when you’re ready to bill.

This article explains both workflows, so you know exactly what to expect.

Before you start

• Lab and imaging orders must be set to Pay in clinic to be billed to the patient
• By default, charges are added to draft invoices
• Draft invoices must be reviewed and issued to collect payment

When automatic charges are enabled

If Auto-charge is enabled in Billing Settings, the system automatically adds lab and imaging charges to a draft invoice as soon as the order is created.

What happens automatically

When you place a lab or imaging order marked as Pay in clinic:

• The charge item is added to the patient’s open draft invoice.
  • The priority is to add to the patient's membership invoice. If not available, the nearest due invoice is selected.
• If no draft invoice exists, SigmaMD creates one

Unless one of the conditions below applies, no payment is collected at this stage, and the invoice remains in draft until it is issued.

When a charge is issued right away

In Billing Settings, under Immediately issue a separate invoice when:, you can choose conditions that put the charge on its own invoice and issue it as soon as the order is sent:

• The membership cycle isn’t monthly
• Any charge item has employer coverage
• Total charge amount is above an amount you set

Meeting any one of them is enough. If the invoice can’t be issued at that moment, you’ll see Unable to issue invoice immediately, and the charge is added to the next draft invoice instead.

Changing the invoice

While the invoice is still a draft, you can click Change invoice during the final step of the ordering flow to:

• Move the charge to a different draft invoice
• Create a new draft invoice (for example, for end-of-day billing)

This gives you full control before charging the patient.

When automatic charges are disabled

If Auto-charge is turned off, charges are not added automatically. In this case, you’ll need to manually create or update an invoice.

On the final screen of the order, click Bill patient on the right-hand side.

Add to Draft or Start New Invoice

SigmaMD will check if a draft invoice already exists for the patient:

• If a draft exists, you can choose to add the new charges to it or start a new invoice.

• If no draft exists, a new invoice is automatically created with the selected tests.

Review and Issue the Invoice

• Make any necessary edits:
  • Manually add or remove charge items.
  • Update the payer.
  • Adjust payment details.
• Click Issue to finalize.

To make further changes, visit the patient's Payments > Invoices screen.

This streamlined billing feature connects the clinical and financial workflows, making it easy to stay organized and ensure every diagnostic order is billed efficiently.

Issuing the invoice and collecting payment

For charges added to a draft invoice:

• Charges stay in draft until reviewed
• Payment is only processed when the invoice is issued
• Issued invoices charge the patient’s selected payment method