Concept explainer
How a charge is created
Explains how a clinical or service event becomes a billable charge and the detail that charge carries into the rest of billing.
A charge is the point where care becomes money. When a chargeable order is placed for a patient, Vault writes a charge against that encounter, and that charge carries every detail the rest of billing reads from. This page follows a charge from the event that raises it to the moment it becomes fixed.
A charge belongs to an encounter
A charge attaches to the encounter rather than to the patient directly. The encounter is the single contact between the patient and the hospital, and the charge, its order and its diagnosis all point back to it.
When a charge becomes real
A charge becomes real the moment a chargeable order is placed. A clinician orders an item in Forge, and Vault raises the matching charge inside the same encounter. The charge names the item, the price that applied, the quantity, and the party responsible for paying.
Medication is charged per dispense, so a charge is raised for each strip or vial issued rather than for each dose given. A service is charged once, at quantity one.
- 1
A chargeable order is placed
A clinician places an order in Forge. The order carries a frozen snapshot of the item exactly as it stood at placement.
- 2
Vault raises the charge
Vault reads the item from the charge master and writes a charge against the encounter, priced at the rate in force on the service date.
- 3
The charge is checked
A set of integrity checks runs as the charge is written. A clean charge lands on the books. A charge that a check flags is held for review before it can sit on an invoice.
What the charge carries
Each charge holds a fixed set of fields. These travel with the charge into invoices, account statements and insurance claims.
encounter string Required | The admission the charge belongs to. |
order string | The order the charge came from. A charge raised at the desk carries a stated reason instead. |
item string Required | The charge master item, snapshotted at the service date. |
price integer Required | The per-unit price frozen at the moment of service. |
quantity integer Required | Units dispensed or performed. One for a service. |
category string Required | The bill category, such as consultation, procedure, investigation or pharmacy. |
split object Required | How much the payer covers and how much the patient owes. |
The charge lifecycle
A new charge starts either on the books or held for review, and moves through a small set of states. A held charge clears to the books once a biller settles the flag, or a biller accepts it as it stands. A charge on the books can later be reversed or cancelled. Reversed and cancelled are the two resting states.
When a charge becomes fixed
A posted charge stays fixed. Its price and its line detail hold as they were on the service date, so a later change to the charge master or to a rate card leaves the charge as it stood. This is effective dating: the charge captures the tariff in force at the moment it was raised.
A correction is a new entry rather than an edit. To undo a charge, Vault reverses it, which keeps the original line and adds a credit note, or cancels it where the charge has yet to reach a finalised invoice. Either way the original stays legible.
A posted charge holds its price
The price on a posted charge is written once and held. Because corrections are added as new entries, the money trail reads exactly as it stood at each point in time, and a reviewer can reconstruct any figure.
Charges accrue before the invoice
A charge and an invoice are separate things. A charge sits on the books as soon as it is raised, ahead of any invoice. An inpatient stay accrues charges over several days, and a single discharge invoice groups them at the end. A charge is settled money detail from the first moment; the invoice is the bill that later gathers it.
Common questions
Is a charge the same as an invoice?
A charge is a single billable line. An invoice groups charges into a numbered bill. Charges exist on the books before any invoice gathers them.
When is a charge raised for medication?
Medication is charged per dispense, once for each strip or vial issued, rather than per dose administered.
Can a posted charge be edited?
A posted charge holds its detail. A correction is added as a new entry, a reversal with a credit note or a cancellation, so the original line stays intact.
Read how the charge master defines each billable item and its base price.