Adding Basic Charges

Date Performed

• Always ensure this is the actual date performed. If the current date is not correct, change it to the correct date performed. 
• Important Note: This is part of the electronic medical record, and it is critically important to ensure the correct date is entered, especially in the event of euthanasia/death of a patient as the performing date prints on the invoice that the owner receives.

Basic Charge Overview

The Visit Type determines the section that is responsible for the patient’s care. It defaults to the visit type entered when the patient is admitted to the hospital in SANDI. This may change if the section in charge of the patient’s care changes, for example, from Small Animal Medicine to Small Animal Surgery. Basically, nearly all procedure codes are marked as taxable because this allows us to apply the two taxes, energy recovery, and sales tax. Whether the tax is applied or not is dependent upon the visit type. Some visit types charge absolutely no tax, some both taxes, and most of the visit types that say nontaxable only charge the energy recovery.

• In Illinois, anything that goes home with the patient is taxable. Anything that occurs within the hospital is non-taxable.
• Many animals come in via the ER and are registered with an initial visit type of ER non-taxable. If the patient is transferred to medicine the visit type should be changed to medicine non-taxable.  The techs typically change this in the EMR. However, it is very important that you check to ensure that the visit type is correct for two reasons:
  1. The visit type triggers what will be taxable and ensure we collect the required tax at discharge.
  2. All of our performance reports are based on the visit type.
• Visit type codes that end in ‘T’ (e.g. SAMT) add sales tax to its line item amount. 
• Ancillary (such as Imaging or Anesthesia) or consulting services are not entered as a Visit Type. 
  • Example: Anesthesia doing a procedure for a Dental patient will be Dentistry Non-Taxable Visit Type.

Adding a Basic Charge

There are both taxable and tax-exempt accounts.

1. When entering the charge screen your cursor will automatically be directed to the procedure entry. (You can also select Add Charge or click the Procedure box.)
2. The box where your cursor is currently focused will be yellow.
3. Searching for a code:  Type at least 3 characters of the procedure code or procedure description. (It is NOT case sensitive).
   1. If there is a single match to your search press enter to select it.
   2. If your search produces multiple results you can arrow to your selection and press enter to select it or use the mouse to click and select it.
4. Watch for Notes: If a procedure code has notes attached to it you will see them in the search box - please read these carefully.

Note: You will be able to type the procedure code and enter, and if all other fields are auto populated (Visit Type, Charge, Qty, Performing Doctor, and Supervising Faculty.) Submit will have a yellow background and you can simply enter to Submit.

Below is an example of two posted charges:

Show Charge Calculation

To see exactly how a charge if calculated, select the edit button next to the item. Show Calculation is automatically selected, and you can see all discounts, fees, taxes, etc. that comprise the price of the charge. (This is the equivalent of the "how" quick command in Vetstar.)

Important Dispensary Information

1. Pharmacy drugs can only be deleted by authorized personnel. This is based on the user's security template in the EMR.
2. Pharmacy drugs are listed in purple.
3. Current weight is required for every patient ordering a prescription 
4. If the prescription is going home, please enter a taxable visit type (e.g. DENT, DERT, EMST, ONCT, OPT, PCT, SAMT, SAST, ZMT). Medications administered in the hospital have nontaxable visit types.

Outside Pharmacy Prescriptions

All prescriptions that go to outside pharmacies must be entered into SANDI using the procedure code “rxout”. This will allow for a record of the prescription within the hospital information system.

1. Enter the procedure charge code rxout in the Patient charge screen as you would any other RX. 
2. Complete the RX instruction screen filling in the name of the Pharmacy, the drug to be dispensed, concentration, dosage form, and instructions for dosing.
3. Indicate refills and for admin click on Owner.
4. After saving the instructions, the RX will need to be double-pinned both on the Doctor Work List and on the Pharmacy Work List. A label will print which may be affixed to a RX form and given to the client.

Add a Prescription Charge

• Once you select submit you will be presented with an Rx Entry box. 
• *Red fields are required. 
• Weight should always be updated.  If a weight has NOT been entered for the current day the the Pharmacy may not proceed with filling the Rx.

Note: The patient Dashboard weight will be updated after you exit (ß) Charges or refresh the Dashboard)

• Once the Rx is Submitted it will go to the Rx Doctor Approval Work-list, if supervising faculty pin is required.  Otherwise it will go to the Dispensary Rx Work-list.

Vaccination Charge

• Once you select submit you will be presented with a Vaccination Tracking window 
• Complete the fields and Submit. 
• Printing a certificate:
  • From the Patient Dashboard select Recalls/Reminders -->
  • Select Health Tracking
  • Select Print Vaccine Certificate in the Upper right Corner of the screen.

Visit Type

The Visit Type determines the section that is responsible for the patient’s care. It defaults to the visit type entered when the patient is admitted to the hospital in SANDI.  The Visit Type may change if the section in charge of the patient’s care changes, for example, from Small Animal Medicine to Small Animal Surgery.  It is important to know that all our performance reports are based on the visit type.

The Visit Type triggers what will be taxable and ensure we collect the required tax at discharge.  In Illinois:

• Anything that goes home with the patient is taxable.
• Anything that occurs within the hospital is non-taxable.

Many animals come in via the ER and are registered with an initial visit type of ER non-taxable. If the patient is transferred to medicine the visit type should be changed to medicine non-taxable.  The techs typically change this in Vetstar.

• Visit type codes that end in ‘T’ (e.g. SAMT) add sales tax to its line item amount. 
• Ancillary (such as Imaging or Anesthesia) or consulting services are not entered as a Visit Type. 
  • Example: Anesthesia doing a procedure for a Dental patient it will be Dentistry Non-Taxable Visit Type.
• To find a different visit type code, simply search in the Procedure box and select the correct Type.

Charge

• The Charge field will automatically be updated to include the price adjusted for quantity and discounts. 

Qty (Quantity)

• Qty defaults to one, enter the appropriate quantity if different.

Performing Doctor

•  The Performing Doctor is the clinician performing/ordering the procedure and entered as the coordinating doctor on the visit during Registration. This will auto populate with the scheduled doctor entered at the time of registration.

Supervising Faculty

• Supervising Faculty is the faculty overseeing the procedure/service area.
• Enter the doctor code for the supervising faculty member on the patient's case into the supervising faculty field, you may search for the faculty if needed.
• You can always ask a technician if you are unsure of who to add. 

Operator

• This will default to whomever is logged into SANDI and entering the charge.  If you add a charge and it is NOT your name as the operator please log completely out of SANDI

Actions

• Select Submit to Post the charge.

Action Icons

Use the Edit Icon to edit a charge.

Use the Delete Icon to delete a charge. If you delete a charge you will be prompted to provide a reason. 

Use the Edit Comment Icon to add a Public or Internal comment a the charge.  

• Internal comments will only appear on the charge in Charges.
• Public comments will appear on the client Invoice right below the charge as shown below.