The following screen will display when you select Add Charge.

Charge & Quantity

Note: Only charge codes with a price of $0 may be altered by a wider user base within SANDI.

• Charge codes assigned a dollar value my NOT be changed and the override of permissions for this is extremely limited.
• Please note that this is the same functionality that was in Vetstar. The SANDI vendor failed to code this into the "Vetstar" version of SANDI. The new SANDI Charges framework returns to the same functionality originally honored in Vetstar.
• VTH Policy #Bill321: Changing Price of Current Procedures

1. Searching for a code:  Type in the charge code or at least 3 characters of the procedure code or procedure description. (It is NOT case sensitive).
   • If there is a single match to your search, press Enter to select it.
   • If your search produces multiple results, you can arrow to your selection and press Enter to select it or use the mouse to select.
   • Adjust the Quantity appropriately. 
   • Watch for Notes: If a procedure code has notes attached to it, you will see them in the search box - please read these carefully.
2. Show Price Calc: This feature will show you what makes up the charge, including items such as standard fee, taxes, fees, and discounts.
   • See full documentation here: SANDI - Procedure Price Calculation (Current and Non-Client) Search
3. Visit: This is the VTH visit for which charges are being entered. It will default to the current open visit.  You can select a different visit from the drop-down list.
4. Performed On (Date): Always ensure this is the actual date performed. If the current date is incorrect, select the calendar icon and change it to the correct date. 
   • 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. The performing date is printed on the invoice that the owner receives.
5. 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. This may change if the section in charge of the patient’s care changes, for example, from Small Animal Medicine to Small Animal Surgery. 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 depends on the visit type. Some visit types charge no tax, some charge 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, you must check to ensure that the visit type is correct for two reasons:
       • The visit type triggers what will be taxable and ensures we collect the required tax at discharge.
       • 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 a Dentistry Non-Taxable Visit Type.
6. Performing Staff: This 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. 
7. Supervising Staff: This is who is overseeing the procedure/service area.
   • Look up the staff member by name or the code for the supervising staff member on the patient's case.
   • Note: You can always ask a technician if you are unsure of who to add. 
8. Comments: Allows the addition of a note/comment specifically associated with the current charge.
   • Public comments will appear on the client Invoice right below the charge, as shown below.
   • Internal comments will only appear on the charge in Charges.
   
9. Overrides: Can be done to the charge description, amount, and percentage of discount. This should only be done by authorized personnel.
10. Current Charges: Expand this to see all current charges on the account. (Refreshes when Submit Charge or Add Another Charges is selected.)
11. Submit Charge: Select Submit Charge or Alt+1 to add the charge and return to the list of charges.
12. Add Another Charge: Select Add Charge or Alt+2 to commit the charge and add another.
13. Cancel: To cancel your current charge entry screen select Cancel or Alt+C. No information for the current charge will be saved. 

List of charges

While a patient's status is set to inpatient, charges entered will be marked as pending. If a patient is not an inpatient when a charge is entered, the charges will be considered posted. 

Pending Charges will stay on the patient's charge screen for multiple days as long as the patient remains inpatient. To convert pending charges to posted charges, the patient needs to be discharged. Once discharged, all of the current charges pending for that patient will be considered posted on that day. Pending charges can be adjusted directly by editing them in the charges screen.

Posted charges can still be edited as long as they are edited on the same day they are posted. They become inaccessible the day after they have been posted, are no longer subject to direct editing, and cannot be converted back into pending charges. To edit a posted charge from the past, an adjustment form will need to be submitted.

Delete Selected

Filters

ACTIONS (Icons)

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

 Use the Edit Icon to edit a charge.

Use the View Details icon to see additional information about the charge, such as who entered it, financial details, etc.

Use the Delete icon to remove the item from the list of charges.

Enter the Rx code or search for the item.

• • *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 a supervising faculty pin is required.  Otherwise, it will go to the Dispensary Rx Work-list.

Rx entry screen will display anytime a drug charge is entered.  

1. Quantity (Unit): Enter the quantity being prescribed. 
2. Dispensing Unit: Form of the item being dispensed.
3. Days Supply: Number of days the drug should be given.
4. # of Refills allowed: Choose from the drop-down.
5. Weight: Always ensure that an up-to-date weight is taken and entered.
6. Administered at: This is where the drug is to be given. (Out-of-hospital is tax eligible.)
7. Instructions: At least one line of instructions is required.
8. PIN: Enter your PIN (most medications require this.)
9. Submit/Add Charge to the list of inpatient charges or select Add Another Charge.

Reference tools: Plumb's Handbook and Exotic Animal Formulary

Incident Report: Used to track medical errors. Select the button for further information.

When a vaccination charge is entered the vaccination entry box will appear.

1. Enter the Rx code or search for the item.
2. Once you select submit, you will be presented with both the prescription information to complete and the vaccine fields.
3. Ensure that you enter the following:
   1. Tag Number
   2. Manufacturer
   3. Serial Number
   4. Number of years to expiration.
   5. Expiration Date
   6. Lot number
   7. Drug expiration date
4. Submit/Add Charge to the list of inpatient charges or select Add Another Charge.

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

Charge Lists, previously called Procedure Packages, Bundles, Work-lists, etc., a list of procedures, inventory items/supplies and/or medications that will automatically pull in the preset list of charges for commonly repeated procedures. Full Documentation is here: SANDI - Charge Lists (Previously called Procedure Packages, Bundles, Worklists, etc.)