Charges

Overview

Charges represent fees for services performed or goods provided. Most health record systems document completed procedures as charges in the ledger. Charges are typically debits, meaning they increase a patient's balance.

Fees, Insurance Claims and Estimates

All response bodies for the charges endpoint include a fee value which is the same as the associated completed procedure's fee. This value can be understood as the amount paid for a medical service or good sold and is calculated based on what providers in the same geographic area usually charge for the same or similar service.

In addition, all response bodies for the charges endpoint may include summed totals from the insurance claim(s) associated with the particular charge such as payment_estimate_total, write_off_estimate_total, and write_off_total. Together, these values indicate how much revenue is expected to be collected from the patient's insurance provider. Please see the insurance claims landing page for more information on these terms.

Use Cases

The NexHealth API does not provide an aggregated patient balance; however, patient balance may be calculated by adding together charges, payments and adjustments associated to a particular patient.

Requesting Additional Associated Entities

For collection queries (/charges), only the id of the associated entities are returned in the response. However, the single :id query can include additional related record details. Please refer to the include[] query parameter on the view charge page for a current list of available options.

Understanding Charges, Procedures and Appointment Relationships

If a charge is associated with a completed procedure, the procedure id may be viewed by adding the query parameter include[]=procedures to the /charges query. However, not all EHRs enforce or even allow this mapping. For more details per integration, please see the "Supported Health Record Systems" section at the bottom of this page.

Where charges include procedure ids, the procedure id may be used to further associate the charge to a completed appointment (charge.procedure_id -> procedure.appointment_id). For records which have null procedures, the charge.charged_at date may be used as a heuristic to find a corresponding appointment.

Supported Health Record Systems