An invoice brings together a client's billable charges for one payer over a billing period. You can review the charges before sending them for payment.
For help understanding line item statuses or why a shift isn't ready to bill, see Line item statuses: when a shift is ready to bill.
Invoices are used for private-pay payers, such as the client, their family, or another direct payer. Insurance and other third-party payers are billed through claims; see Add to Invoice vs. Add to Claim and When a claim is rejected or denied for that process.
How shifts are added to an invoice
Careswitch usually adds completed shifts to billing automatically. It adds the billable charges to an Open or Paused invoice for the same client, payer, policy, and billing period. If no matching invoice is available, Careswitch creates a new one. This can happen when the previous invoice for that period has already been marked Reviewed or sent.
Related charges are collected in an invoice group, which you review and send as one bill. Charges are grouped by client, payer, policy, and billing period. The payer’s Invoice Frequency determines how often billing occurs, and Billing Week sets the starting day for weekly or biweekly billing.
For more details, see Invoice groups and Changing how a client pays: payment method, billing week, and frequency.
A completed shift isn't added automatically in two cases:
It has an unresolved blocking AI Shift Review exception. You'll need to review it first. See How AI Shift Review Works.
No active policy covers its service on that date.
Fixing the issue doesn't add the shift on its own. Add it from the shift page (Add to Invoice) or from the invoice's missing-shifts check (below). For more, see Line item statuses: when a shift is ready to bill.
Create an invoice manually
Tip: You can also ask Looper to create the invoice for you.
To create an invoice yourself, go to Billing → Invoices → Create Invoice
Choose:
Client
Payer: a private-pay payer linked to the client through an active policy.
Service: only services covered by an active policy for that client and payer appear. A service also needs to be active, have a start date, and have a signed care plan.
Start Date and End Date for the billing period.
If the client doesn't have a policy linking them to a payer, Careswitch asks you to create one first, with a Manage policies link. The policy tells Careswitch which services to bill and what to charge. See Creating a Private Pay Policy.
Review and adjust charges
Before sending the invoice, review its line items, including shift hours, travel time, and mileage, along with expenses, the amount due, and any convenience fee.
You can add, remove, or edit line items while the invoice is Open or Paused. Marking the invoice Reviewed or sending it locks the items.
For help adding expenses, mileage, or rate modifiers, see Expenses, mileage, and rate modifiers on a bill.
Check that the invoice is complete
While the billing period is still running, the invoice shows Billing Period is Ongoing. More work can still land on it, so wait for the period to end before treating it as final.
After the billing period ends, the invoice page lists any shifts from that period that aren't on the invoice yet.
They're sorted into four groups, each with its own button:
Group | What it means | What to do |
Ready to add | Completed shifts with Billable items and nothing holding them back. | Click Add, or Add all ready to add every one. |
Needs review | Completed shifts held by a blocking AI Shift Review exception, or with no bill rate. | Click Review to open the shift, fix the issue, then add it. |
Incomplete | Shifts that ended without being completed (for example, no clock-out). These are the shifts whose line items show as Missed. | Click Complete. If the visit happened, complete the shift and it becomes billable. |
Not worked | Shifts that never got to a worked state, such as still scheduled or unassigned. | Click Resolve to cancel, reschedule, or complete the shift. |
When nothing is missing, the invoice shows Ready to Send.
If you send the invoice, download it, or use Mark Sent while shifts are still missing, Careswitch warns you first.
Mark an invoice Reviewed or put it on hold
These two statuses help you manage the review process. Both are in the Actions menu.
Reviewed: the invoice has been checked and is ready to send. It locks against edits, and Careswitch records who marked it reviewed and when.
Paused: the invoice is on hold. You can still edit it, and it keeps picking up completed shifts, but it can't be sent.
To edit a Reviewed invoice, or take a Paused one off hold, choose Mark Open.
Move line items to another invoice
You can move shift hours, travel time, mileage, and expenses to another invoice, individually or as a group.
Select the items using their checkboxes, then click Move to invoice.
Choose the Destination invoice:
An existing invoice. It has to be an open invoice for the same service and payer.
A new invoice. If one already exists for that period, Careswitch notes that you're creating a second invoice for it, and that future shifts will keep going to the existing one.
A move keeps rates, payers, and amounts exactly as they were. Items from different services can only move to a new invoice.
If your selection covers whole shifts, you can also choose a different Billing policy. Doing so re-bills those shifts at that policy's rates, so amounts can change, and moves any expenses along with them.
You can move items only while their invoice is Open or Paused. Once the invoice is Reviewed or sent, its items are locked.
Send the invoice
How you send depends on the payer's Invoicing Method:
Embedded Billing (online payments): Send Invoice emails the payer a secure link to pay online. Charge Now charges their verified card or bank instead.
Email Invoice: Send Invoice emails the invoice. The payer needs an email address on file. Use Resend Invoice to send it again.
Print Mail Invoice: Download Invoice gives you the PDF (plus care notes, if the payer is set up for them) and saves a copy to the client's documents. The first download marks the invoice as sent.
Fax Invoice or Payer Portal: deliver it the way you normally do, then choose Mark Sent.
An invoice with a $0 balance can't be sent or charged.
You can also download the invoice from the Export menu:
a Standard Invoice PDF
one PDF per service
a Full Packet (invoice plus care notes) for payers set up to receive care notes
To email a copy to someone else, choose Actions → Send Copy. You can pick from the client's contacts or type in any email, and optionally include a payment link.
For details on how clients pay online, see Collecting private-pay payments and convenience fees.
Record payments
When a payment arrives outside online payments, record it from the Actions menu:
Mark Paid: paid in full. On Embedded Billing invoices it's called Mark Paid out of Band.
Record Payment: part of the balance, as one amount or by service. A payment larger than the balance shows the invoice as Overpaid; card and bank payments can't go over the balance.
Add Adjustment: writes off some or all of the remaining balance, with a reason.
Invoice statuses
Invoice status | What it means | Line items |
Open | The invoice is being prepared. | Billable, editable |
Reviewed | Checked and ready to send. | Billable, locked |
Paused | On hold; can't be sent. | Billable, editable |
Sent | Delivered to the payer. | Billed, locked |
Processing | An electronic (Stripe) payment is being processed. | Billed, locked |
Paid / Partially paid | Full or partial payment received. | Locked |
Failed | An electronic payment didn't go through. Click Charge Now to retry. | Locked |
Void | Canceled. | — |
Change an invoice after it's sent
Mark Reopened brings a sent invoice back to Open and its line items back to Billable, so you can edit it and send it again. If the invoice was in QuickBooks, Careswitch voids the QuickBooks copy, and the next send creates a fresh one.
On Embedded Billing invoices, use Mark Void and Reopen instead.
Mark Void cancels the invoice. If there's a separate invoice for the same period, Careswitch asks which one future shifts should go to.
A reopened invoice can get a new invoice number when it's sent again.
Attach client documents to an emailed invoice
You can attach documents already saved on the client's profile to the invoice email.
This is helpful when a payer needs supporting paperwork, such as a signed service agreement, care plan, or doctor's order.
Open the invoice group and choose to send or resend the invoice by email. In the Send Invoice dialog, select Attach client documents.
Choose files from the client's document list. The newest files appear first, and each shows its upload date. You can search by name and choose up to 5 documents per send.
Send the invoice as usual.
Keep these details in mind:
The option appears when the invoice is delivered by email, the payer is an organization contact, and you have permission to view client documents.
The list contains files already in the client's Documents tab. Selecting files here doesn't upload new documents. If a file isn't available yet, choose Upload a document to the client profile from the dialog, then return to attach it.
Each email can include about 18 MB of attachments. If your selection is too large, Careswitch asks you to deselect some documents.
The invoice's Activity records the send, including the recipient's address and the name of each attached document.
Invoice numbers
Every invoice, including reimbursement invoices, has a consistent invoice number, such as CS-PP-1023. The middle letters show the payment type: PP for private pay, plus codes such as LT (long-term care), AA (area agency on aging), and RB (reimbursement invoice).
The same number appears on the invoice page, PDFs, emails, payment pages and receipts, exports, and file names. You can search for an invoice by its number in the invoice tables or global search. If you sync with QuickBooks Online, the invoice number in QuickBooks matches the number in Careswitch.
The invoice activity feed
Each invoice group has an Activity history at the bottom of the invoice page. It records:
creation and edits
status changes
sends and resends, including attached document names
payments and adjustments
For activity recorded on insurance claims, see When a claim is rejected or denied.
Monitor your invoices
The Billing → Invoices tab has four summary cards at the top:
Submission Ready: billing that is ready to be sent. It includes invoices whose billing period ended within the last 180 days, or 240 days if they were previously sent and then reopened.
It includes Reviewed invoices and excludes Paused invoices. For insurance and other third-party payers, it also excludes Reopened invoices because those are corrections to claims that have already been submitted.
Total Paid and Total Outstanding: totals for sent invoices. Invoices that were never sent, voided invoices, and reimbursement invoices aren't counted.
Total Billed is the full amount of every invoice and claim that has gone out to a payer (sent, paid, partially paid, failed or denied), using the table’s current filters. Unsent, void and reimbursement invoices aren’t included.
Click a card to filter the table to the invoices behind it. Use Totals for to choose whether the Paid, Outstanding, and Billed cards cover all matching invoices or only the current page. Submission Ready always covers everything and ignores the date filter. Use Invoice Age to filter by how long invoices have been outstanding.
An indicator next to Billing in the navigation lets you know there are invoices waiting to be sent. Open the Receivables tab to see how much each payer owes and how long those balances have been outstanding.
FAQ
Why can't I create an invoice for this client?
The client needs an active private-pay policy linking them to the payer, and the service must be covered by that policy. The service also needs a start date and a signed care plan. Set those up first. Insurance payers are billed through claims.
Why isn't a shift on the invoice?
Check the invoice's missing-shifts list. It tells you whether the shift is Ready to add, Needs review (a blocking exception or a missing rate), Incomplete, or Not worked, and gives you a button for the next step. Shifts aren't re-added automatically after you fix them, so add them from the list or the shift page. See Line item statuses: when a shift is ready to bill.
Why are there two invoices for the same period?
Usually because the first one was already Reviewed or sent when a later shift was billed, or because the charges are under a different payer or policy. See Invoice groups.
Can I change an invoice after sending it?
Yes. Choose Mark Reopened from the Actions menu (or Mark Void and Reopen for Embedded Billing invoices). The invoice goes back to Open and its line items become Billable again, so you can edit it and send it again. To cancel it entirely, use Mark Void.
How do I edit an invoice I marked Reviewed?
Choose Mark Open. The invoice unlocks so you can make changes, then mark it Reviewed again when it's ready.
A client paid part of the invoice. How do I record it?
Choose Actions → Record Payment and enter the amount, as one total or by service. The invoice shows as Partially paid until the rest comes in.
Why don't I see "Attach client documents" when sending an invoice?
This option appears only when the invoice is delivered by email, the payer is an organization contact, and your role has permission to view client documents. If the client doesn't have documents yet, the dialog provides a link to upload one to their profile.