Billing at a Veterinary Clinic: How to Reduce Unbilled Services

During a visit, it may be necessary to record several procedures, materials, supplies, medications, and counseling services. If the information is compiled only after the consultation, billing will depend on notes and the staff’s memory. The risk increases when multiple staff members are involved, or when the visit continues after an initial billing record has already been created.

Missed charges are rarely intentional. They occur during the transition from work performed to a recorded billing line item. A traceable workflow between consultation and invoice makes it easier to see where the data goes missing.

The Process from Consultation to Invoice

Track a number of completed visits throughout the entire process. This will allow you to determine whether the discrepancy occurs during the documentation of the visit, when the billing data is compiled, or during the final invoicing.

The consultation is being conducted. Anyone who performs or participates in a task needs to record relevant information close to the time the work is performed. The same applies to materials used and other items that affect billing.
The medical record entry is completed. The details of the consultation are summarized in the medical record. The veterinarian in charge reviews the entry and confirms that it accurately reflects the visit.
The billing document is created. The medical record is compared with the clinic’s price list and billing rules. Not all medical record information should automatically become billing lines, but the document should make it possible to verify the relevant entries.
The invoice is reviewed. The front desk or another designated department compares the billing lines with the audited supporting documentation. Unclear entries are sent back to the person who can determine what work was actually performed.
Discrepancies are followed up on. Retroactive charges and other adjustments are recorded. Recurring discrepancies indicate where the workflow needs to be reviewed.

The review should cover the entire visit, even when multiple people have worked with the patient. Otherwise, an invoice created early in the visit may not include items that were added later.

Situations in Which Charges Are Waived

The following situations are worth examining in your own organization:

Several procedures are performed during the same visit, but the basis for billing is primarily based on the original reason for the appointment.
The veterinarian and the veterinary technician record various aspects of the visit without a joint review before the invoice is finalized.
Materials or medications are added after an initial list has already been sent to the front desk.
The journal is written retrospectively based on brief notes that do not mention any actions taken.
Counseling or follow-up care is documented in the medical record, but no one checks whether it complies with the clinic’s billing policies.

Double charges and incorrect entries must also be included in the review. The goal is for the invoice to reflect the work that has been performed and the clinic’s established policies, not for every mention in the medical record to be billed.

Assign responsibility for each handoff

Start by assigning a person in charge for each handoff. This may be a different person depending on the type of visit, shift, or the size of the clinic.

The veterinarian is responsible for ensuring that the medical record accurately reflects the consultation and that the actions taken are correctly documented.
The veterinary technician records the work and supplies that fall within their area of responsibility.
The front desk verifies that the supporting documentation is in order before the invoice is finalized.
The finance department monitors corrections and recurring discrepancies without having to make clinical assessments.

Everyone needs to be able to indicate when tasks remain. Statuses such as “started,” “awaiting completion,” “ready for billing,” and “invoiced” can work well if they fit the clinic’s system. Try out the division of labor on a small scale first: a clinic with a central reception desk often needs a different checkpoint than a practice where the same person concludes the visit and collects payment.

The medical record is the basis for accurate billing

A complete medical record entry provides more information to compare with the billing lines, and a clear structure makes it easier to find the procedures performed and products used without having to read the entire entry several times.

This is where most missed charges originate. When the medical record is written retrospectively, from memory, it’s easy for a minor procedure to be omitted, and anything not included in the medical record is rarely billed. The closer the medical record is written to the time of the consultation, and the more complete it is, the better the basis for billing will be. Common shortcomings in medical record entries are described in “The Most Common Mistakes in Medical Record Writing.”

Billing Proposals Using AI in Vetz

Vetz provides automatic suggestions for what should be billed, based on the contents of the medical record. The goal is to reduce the risk of missed billing by linking the documented information to the items billed.

The proposals are based on the same workflow as medical record-keeping. Vetz listens during the conversation with the pet owner and creates a structured draft of the medical record, so that the record is completed immediately following the visit rather than afterward. The veterinarian reviews and approves the medical record, and the billing proposals are based on the approved notes. Once integration with the medical record system is active, the completed note is transferred with the click of a button. How the workflow functions is described in “AI Medical Record Keeping for Veterinarians ” and “How Vetz Works.”

The billing proposals are a guide, not a final invoice. The person responsible for invoicing checks the proposals against the clinic’s price list and billing rules before finalizing the invoice. An overview of all features is available on the Vetz features page.

Measure the improvement over a test period

Select a specific test period and determine in advance which visits to include. Use the same sample for a comparison period so that the results are comparable. We recommend tracking these metrics during both periods:

Percentage of captured charge entries: the number of relevant entries with a corresponding charge line, divided by the total number of relevant entries according to the clinic's rules.
Percentage of corrected invoices: the number of invoices that are amended after the initial review, divided by the total number of invoices reviewed.
Value of retroactively recorded entries: the amounts that have been added after the original invoicing.
Time to completed invoice: from the end of the visit until the invoice has been reviewed and finalized.

Also note the cause of each deviation. Recurring causes indicate which step in the workflow needs improvement. For more information on how to measure time savings, see “Save Time with AI for Veterinarians.”

Questions About Information Security

When conversations and medical records are processed using AI, the clinic needs to know what data is being processed and how. The clinic should have written answers to the following questions before implementing a tool:

Where are audio files, transcripts, and draft records processed and stored?
How are access permissions managed, and can the clinic track who has had access?
How long is the data retained, and how are deletion and export carried out?
Which subcontractors are involved, and how are security incidents handled?
How is the pet owner informed that AI is used in the medical records?

It is advisable to ask these questions directly to the supplier before entering into a contract. The clinic’s data protection officer should then evaluate the responses based on the organization’s own procedures.

You can try Vetz for free for 14 days. Clinics that want to see how the billing suggestions work within their own workflow can schedule a demo.