Treatment cases and the ledger

Bill a course of treatment over time and track what each patient still owes.

Homeopathy is rarely one visit and one bill. A treatment case is the folder you open for a course of treatment — a diagnosis, the date you started it, and what you expect it to cost — so that months of visits, prescriptions and invoices belong to something rather than floating on their own. The Accounting Ledger is the other half of the story: every invoice, payment, credit note and refund your clinic has ever raised, in one immutable running list.

Admin/c/your-clinic/admin/billing/treatment-cases

What a treatment case is

A treatment case groups one patient's multi-visit treatment under a single case number — CASE-000001, CASE-000002 and so on, numbered per clinic. It records the Diagnosis, when treatment Started, an optional expected end date, an optional Estimated Cost, and a status. Invoices raised over the course of the treatment can be attached to the case, and the case row shows how many are attached.

Create a treatment case

From the Billing Dashboard, click the Treatment Cases tile, then New Treatment Case at the top right. (The empty-state button is called Create Treatment Case — it goes to the same form.)

1
Find the patient
In the Patient card, type at least 2 characters of the patient's name, email or phone into Search patient by name, email or phone... and click them in the dropdown. The card then shows their name and contact — click the x to swap to a different patient. Create Treatment Case stays greyed out until a patient is chosen.
2
Type the Diagnosis
This is the only required field besides the patient. It is what you and your colleagues will search on later, so write it the way you would say it: Chronic Migraine, Eczema, Anxiety.
3
Add a Description (optional)
A couple of lines about the case — the presenting picture, the plan, whatever helps the next person who opens it.
4
Set the Status
Defaults to Active. You can also open a case straight into On Hold, Completed or Cancelled, though in practice you almost always want Active.
5
Set the dates and the estimated cost
Start Date defaults to today and cannot be a future date. End Date (optional) cannot be earlier than the start date — leave it blank while treatment is ongoing. Total Estimated Cost (₹) (optional) is what you expect the whole course to come to.
6
Add Notes and click Create Treatment Case
A Treatment case created successfully message confirms it, and you are returned to the Treatment Cases list. Cancel goes back without saving.

The Treatment Cases screen with the search box, status filter and the New Treatment Case button — Each case row carries the case number, its status pill, the patient, the start date, how many invoices are attached, the diagnosis, and the estimated cost on the right.

Diagnosis *: Required. The condition being treated. Searchable from the list.
Description: Free text. A short summary of the case.
Status: Active, On Hold, Completed or Cancelled. Defaults to Active.
Start Date: Defaults to today (IST). Cannot be in the future.
End Date (optional): Cannot be before the start date. Leave blank until treatment finishes.
Total Estimated Cost (₹) (optional): What you expect the course to cost. Purely informational — it is not billed, and it is not compared against the invoices automatically. Left blank, it shows as ₹0.
Notes: Anything else worth recording against the case.

Case statuses

Status	What it means
Active	Treatment is running. This is the default for a new case.
On Hold	Paused — the patient has stepped away, or you are waiting on a report or a decision.
Completed	The course of treatment is finished.
Cancelled	The case was abandoned or opened by mistake.

The same four values appear in the status dropdown on the list and on the create form.

Finding a case again

The Treatment Cases screen has two controls, and they work together:

Search by case number, patient, or diagnosis... — type any part of the case number, the patient's name or the diagnosis.
The status dropdown — All Status, Active, Completed, On Hold, Cancelled.

Billing against a case

There is no button anywhere in the app that attaches an invoice to a treatment case — the link exists in the system but not on any screen. In day-to-day practice this means you bill a long treatment exactly as you bill anything else, one invoice per visit:

The consultation fee and any prescribed medicines become a pending invoice automatically as soon as the doctor completes the consultation. See Invoices.
Take the money over the counter with Quick Bill, or open the invoice and click Record Payment — part-payments are allowed, which is what makes a long course affordable for the patient. See Payments and refunds.
Medicines sold from stock go through Pharmacy billing, which checks inventory before it bills.

The accounting ledger

Admin/c/your-clinic/admin/billing/ledger

Billing Dashboard → Ledger opens the Accounting Ledger — an immutable record of all financial transactions. Every billing action writes one line here automatically, and no line can ever be edited or deleted from the app. It is the answer to "where did this money come from, and where did it go".

When this happens	The ledger records	Shown as
An invoice is raised	A Debit — the patient now owes the clinic	Type Invoice, amount in the Debit column
A payment is recorded	A Credit — the debt goes down	Type Payment, amount in the Credit column
A credit note is issued	A Credit — the invoice is written down	Type Credit Note, amount in the Credit column
A refund is processed	A Debit — money has gone back out	Type Refund, amount in the Debit column

Debits raise what is owed to the clinic; credits reduce it. You may also see Adjustment, Debit or Credit as a type on older or corrective entries.

The Accounting Ledger with Total Debits, Total Credits, Net Balance and Total Entries cards above the entry table — Read a row left to right: which entry, when (IST), what kind of transaction, the description carrying the invoice number, then the money — Debit, Credit, and the balance that followed.

Reading a ledger row

Entry #: A short reference for the entry. It is not a running serial number, so do not read anything into the order or expect it to count upwards.
Date: Date and time the entry was written, in IST.
Type: Invoice, Payment, Credit Note, Refund or Adjustment — what caused the entry.
Description: The sentence written at the time, e.g. the invoice number the payment was for and the method it came in by. On narrow screens this column is hidden and appears inside the row card instead.
Debit: Money the clinic is owed, added by this entry. Blank (—) on credit entries.
Credit: Money that settles or reduces what is owed. Blank (—) on debit entries.
Balance: The running balance for that patient immediately after the entry. Because the ledger interleaves every patient's entries in one list, this figure jumps around as you scroll — it is not a clinic-wide total.

Filters and the summary cards

All Types — narrow to Debit or Credit entries only.
From and To — restrict the ledger to a period, for example one month for your accountant.
Clear — appears once any filter is set, and resets all three at once.

Four cards sit above the table and cover the whole date range you have chosen, not just the page you are looking at: Total Debits (everything invoiced), Total Credits (everything collected or credited back), Net Balance (debits minus credits — what is still owed across the period) and Total Entries.

Finding what a patient still owes

The ledger proves what happened, but it is not the fastest way to answer "how much is this patient short?" — it has no patient column and no per-patient view. For outstanding balances, use these instead:

Question	Where to look
What does this one patient owe?	Invoices — search their name and read the Amount Due on each invoice. Pending and Partial are the two statuses that still carry money.
What is the clinic owed in total, right now?	The Outstanding card on the Billing Dashboard, and the Outstanding Invoices panel beneath it (the five oldest by due date).
Who is overdue, and can I get it in a spreadsheet?	Billing reports — the billing tab lists Outstanding Invoices and Export CSV downloads exactly that table.
How much was owed across last month as a whole?	This ledger — set From and To, then read Net Balance.

Can a doctor open a treatment case?+

Not from the screens. The Treatment Cases list and the New Treatment Case form are admin-only — a doctor who lands on them is turned away with Access denied. Admin account required.

I created a case and the list is still empty. Did it save?+

Yes. The success message means the case was saved with its own case number. The list simply is not displaying saved cases at the moment — see the known issue above.

Does the estimated cost warn me when the invoices go past it?+

No. Nothing compares the case's Total Estimated Cost against the invoices raised. It is a reference figure for you, not a budget the system enforces.

Why does the Balance column go up and down instead of only growing?+

Because it is a per-patient running balance, and the ledger lists every patient's entries together in date order. A payment from one patient will pull that patient's balance down while the next row belongs to someone else entirely.

Can I delete a wrong ledger entry?+

No — that is the point of it. Cancel or refund the invoice that caused it; the correction is written as a new entry and both lines stay visible, which is what an audit trail is for.

Who changed this invoice, and when?+

The ledger records the money; Billing → Audit Logs records the people. It shows every create, update and delete in billing with the user, their role, the time and the fields that changed.

Invoices

Raise, find, edit and cancel invoices, and read the six invoice statuses.

Payments and refunds

Record a payment, take a part-payment, and process a refund with a reason.

Billing reports

Revenue by date range, payment-method breakdown, outstanding invoices and CSV export.