Automatically Adding Charges to Draft Invoices

The Auto-charge option helps practices reduce manual billing steps by automatically adding eligible charges to a patient’s open draft invoice.

When enabled, SigmaMD handles where charges go based on the patient’s membership and existing invoices. When disabled, billing works exactly as it does today, with charges added manually.

This article explains how Auto-charge works, what happens when it’s disabled, and how you can adjust invoices before charging the patient.

Where to find the Auto-charge setting

Auto-charge is available in Billing Settings.

• Go to Settings → Billing.
• Under Charge item handling, toggle Enable automatic charges.

This setting applies at the practice level.

How Auto-charge works

When Auto-charge is enabled, SigmaMD automatically adds charge items to a draft invoice when any of the following actions happen:

• A lab or imaging order marked as Pay in clinic is created.
• A medication is dispensed.

Charges are added following the workflow below.

How SigmaMD selects the invoice

When an eligible charge is created, SigmaMD checks:

• Is the patient associated with a membership? (Including non-paying dependents)
  • If Yes: Charges will be added to the membership draft invoice
  • If No: Does the patient already have an open draft invoice?
    • If Yes: If multiple invoices exist, the nearest due invoice is selected
    • If No: SigmaMD creates a new invoice.

Charges are never issued automatically. They are only added to draft invoices.

Changing the invoice before charging

Even with Auto-charge enabled, you stay in control.

While the invoice is still a draft, the final step of the ordering or dispensing flow includes a Change invoice option.

From there, you can:

• Move the charge to another existing draft invoice.
• Create a new draft invoice (for example, end-of-day billing instead of a membership invoice).

This makes it easy to adjust billing without removing and re-adding charges.

When charges are actually billed

Auto-charge only adds items to draft invoices.

To charge the patient:

• The invoice must be reviewed and issued.
• Issuing the invoice is what triggers payment using the patient’s payment method.

Until the invoice is issued, no payment is collected.

What happens when Auto-charge is disabled

When Auto-charge is turned off, SigmaMD keeps the current behavior:

• Lab, imaging, and medication charges are not added automatically.
• Charges must be manually added to an invoice. See here how to do it.

This option is ideal for practices that prefer full manual control over billing.