How Do I Bill a Session From Start to Finish?
Published: October 26, 2026
Last updated: October 26, 2026
How Do I Bill a Session From Start to Finish?
This article walks through the basic billing workflow in Ambiki, from scheduling a session to recording the payment. Following these steps in order keeps your event, visit note, treatment report, invoices, and claims linked together, so tasks and notifications match up.
If you bill a contracted facility instead of a patient or insurance company, see How to Log a Facility Invoice For a Treatment Done In a Facility.
At a Glance
- Saving billing data on a visit note creates its treatment report.
- Billing starts once the visit note is signed and billing data is saved.
- Insurance patients get an invoice for each insurance on file.
- A copayment invoice is created automatically when the insurance has a copay set.
- Private pay patients get an invoice for their private pay method.
- Your claim submission setting decides when insurance claims are sent.
Requirements
For billing to work, the following must be in place:
- Billing provider information and default service rates. See How to Add Billing Provider Information and Default Service Rates.
- An active payment method on the patient profile for the date of service: an insurance, a private pay method, or both. See How to Add a Patient's Payment Method to Ambiki.
- For copayments, a copay amount on the patient's insurance. See How to Add a Copayment Amount to An Insurance Method.
- For electronic insurance claims, the insurance company set up for claim submission. See Set Up Insurance Companies You Work With On Ambiki.
How Do I Bill a Session?
Therapists will usually follow steps 1-5, while admin usually follow steps 6-7.
Step 1: Schedule the session - Can be handled by either therapist or admin
On the Schedule, create an event for the patient. See How Do I Schedule Single or Recurring Events?.
Step 2: Take attendance and open the visit note - Can be handled by either therapist or admin
From the scheduled event, set the patient's attendance, then click the visit note icon to start the note for that session.
Step 3: Write and save the visit note - Can be handled by either therapist or admin
Complete the visit note and click Save.
Step 4: Add the billing data - Can be handled by either therapist or admin
On the visit note, click Actions, select Billing, confirm the billing codes and units, and click Save billing data. This creates the session's treatment report.
Step 5: Sign the visit note - Handled by therapist
Review the visit note and sign it. Once the note is signed and the billing data is saved, Ambiki creates the invoices for the session (see "What Happens After You Sign" below).
Step 6: Find the invoices - Typically handled by admin
On the patient profile, click the Payments tab to see the invoices created for the session.
Alternatively admin can access invoices by going to Billing then scrolling down to Patient billing and clicking on Patient invoices.
Step 7: Record or collect the patient's payment - Typically handled by admin
Open the patient's invoice and click Add payment to charge a card on file or record a payment made another way. See How to Record a Payment Made On a Claim or Outstanding Invoice (Including EOBs).
Patient invoice with a recorded payment:
Private Pay Patients
Ambiki creates an invoice for the patient's private pay method. If you already created the invoice from the event on the schedule, Ambiki updates that invoice instead of creating a second one.
Insurance Patients
- Insurance invoices: Ambiki creates an invoice for each active insurance on the patient profile, such as a primary and a secondary insurance.
- Copayment invoice: if the insurance has a copay amount, Ambiki also creates a copayment invoice for the patient. If you already created the copayment invoice from the event on the schedule, Ambiki links to that invoice instead of creating a second one.
- Insurance claims: Ambiki creates an electronic claim for each insurance set up for claim submission.
When Insurance Claims Are Sent
Your organization chooses when claims are sent in Organization → EMR settings → Insurance billing, under Electronic insurance claim submission:
- Immediately: the claim is sent as soon as the therapist signs the documentation.
- After a delay: the claim is sent after the delay you choose, counted from the time the therapist signs.
- Manually: an admin submits each claim. This is the default when no option is selected. See How to Submit a Pending Claim File.
A claim is only sent when all required information is present. If something is missing, the claim waits until you correct it. See How to Resubmit a Rejected Billing Claim and How to Edit a Claim File In Error.
Q&A
Q: I signed the visit note but no invoice was created. Why?
A: Check that the billing data was saved and that the patient has an active payment method for the date of service. Ambiki only invoices payment methods that are active on that date.
Q: Can I collect a copay or private pay amount at the visit, before the note is signed?
A: Once attendance is taken, the event on the schedule shows the copay or private pay amount with a link to create the invoice. When the note is signed later, Ambiki uses that invoice instead of creating a duplicate. While both ways are possible, we do recommend allowing Ambiki to automatically generate the invoices after the note is signed to ensure everything stays connected.
Q: Why wasn't a claim sent for my insurance patient?
A: Your organization may use manual claim submission, the claim may still be in its delay period, or the claim may be missing required information. See How Do I Turn On Automated Insurance Billing So That My Claims Automatically Submit?.
Q: I need to change the billing after the invoices were created. What should I do?
A: If you need to change a CPT code or modifier and no claims have been sent out and no payments have been applied, see How to Customize Treatment Modifiers and Make Edits to Treatment Reports to edit your treatment report. You can then "reload" the invoices to apply those changes.
If you need to make changes and claims have already been sent out or payments have been applied, see Corrected Claims: Cancellation Vs. Replacement Vs. Reinvoicing to choose the right correction for your situation.
Q: How do I bill a contracted facility instead of the patient?
A: Facility billing uses a different workflow. See How to Log a Facility Invoice For a Treatment Done In a Facility.
Heather Roulston