Keeping track of patient transactions can get complicated, especially when multiple payments, codes, and adjustments are spread throughout the ledger. That is where the Group by DOS (Date of Service) feature helps: it brings clarity and structure to your ledger at a glance.
Topics Covered
- What does Group by DOS do?
- Understanding the Group by DOS Layout
- What is NOT Grouped in a DOS Ledger?
- Understanding the Dollar Values in the DOS-Group Header
- Summary Footer
- Filtering
Watch this video for a quick overview.
Let's get started!
- Search for the patient using the Global Search bar.
- Select Ledger.
OR
- Navigate to the Patient Overview.
- Hover over Billing > select Ledger.
Click the ‘Group by DOS/DOP’ toggle button to group the ledger into DOS accordions.
| Tip: Once you toggle on Group by DOS, the system remembers your preference. The setting is saved per user and preserved across logins, so you do not have to re-enable it each time. |
What does 'Group by DOS' do?
When Group by DOS is turned on, the ledger view changes from a flat list of transactions to a structured, grouped layout. This makes it easier to:
- View completed codes for that visit.
- Identify pending actions like unpaid balances or unresolved claims.
- Navigate and manage transactions more efficiently.
Understanding the 'Group by DOS' Layout
Now, let's explore each item from left to right.
1. Indicator Icon: The icons are one of two types,
a. Green checkmark: Everything is settled and no action is required.
b. Red icon: Attention is required (e.g., a balance due or a pending claim).
2. Date: Depending on the transaction type, the date shown will be:
- Date of Service for Code groups.
- Date of Payment for Unapplied Payment receipts, refunds & adjust-off standalone groups.
- Date of Generation for Statement standalone groups.
- Date of Transaction for Pre-Auths, bankrupt, inactive & any other standalone groups.
3. Alert phrases like 'Claims Pending' or 'Unapplied Credits' appear when follow-up is needed.
- Click on the Alert Phrase to navigate to the related transaction.
4. Balances: The Net Patient and Insurance Balances (both dues and estimates) are displayed on the group header. Refer the below section 'Understanding the Dollar Values in the DOS-Group Header' for a deeper understanding on these figures.
5. Click the Expand icon to view the detailed transactions related to that DOS. You can also click anywhere on the row to expand it.
6. To Print all the transactions connected to a Date of Service,
- Click the three dot menu.
- Select Print DOS Transactions.
| Note: Ledger Print is unavailable when Group by DOS/DOP toggle is turned on. |
What is NOT Grouped in a DOS Ledger?
- Advance payment receipt / Receipts having Unapplied Credits (displayed as ‘Patient Payment’) - since they are not linked to any specific codes.
- Pre-Authorizations that are not linked to a checked-out code - since a DOS Group will be formed only if there is a checked-out code in it. Until the Code linked to the Pre-auth is checked out, it will remain as a standalone group.
- Refunds - since they are not linked to any specific codes.
- Adjust-offs - since they are not linked to any specific codes.
- Statements - Not supported by the system at the moment
- Patient has been marked as Bankrupt - since they are not linked to any specific codes.
- Patient has been marked as inactive - since they are not linked to any specific codes.
Understanding the Dollar Values in the DOS - Group Header
Explore this video for an in-depth walkthrough.
Now, let's explore the dollar value balances in the accordion header. Take a look at the below image which showcases a DOS group dated 09/15/2025.
Tip: Hover over the dollar values of balances to view the tooltips. |
Note the three Dollar Figures in the DOS Header:
- Net Charges $1,550
- Ins. Due $330 / $330
- Pat. Due $720 / $1,220
“Patient Due $720 / $1,220” is represented in an A / B format, where ‘A’ represents the Remaining Patient Due and ‘B’ is the Patient Estimate; for that Date of Service.
Similarly, Insurance Due is presented as $330 / $330 to indicate Remaining Insurance Due / Insurance Estimate; for that Date of Service.
Let’s dive into each figure in detail.
1. Net Charges $1,550
- This is the Sum of the Pat. Estimate + Insurance Estimate +/- includes any Adjustments.
- This figure denotes the net value that the practice has produced for that Date of Service.
2. Ins. Due $330 / $330 – is to be read as “Insurance is due $330 out of the insurance estimate of $330”
- Ins. Due = $330 → The remaining amount the Insurance has to pay, for that DOS.
- The code D3330 was checked out, resulting in an Insurance Due of $300 and also the Insurance Estimate as $300.
- There was an Insurance Adjustment (ADJ-ON) of $30 → which results in Ins. Due being increased to $330, and the Ins. Estimate increased to $330
- No Insurance payments were made.
- The final amount is derived by Insurance Estimate minus Insurance Payments ($330.00 – $0.00).
- Ins. Estimate = $330 → The net value charged to Insurance, for that Date of Service.
- Indicates the Total insurance responsibility (includes adjustments)
- This is derived by the Base Insurance Estimate ($300.00 from D3330) plus Insurance Adjustment (Insurance Adj On of +$30.00).
3. Pat. Due $720 / $1,220 – is to be read as “Patient is due $720 out of the patient estimate of $1,220”
- Pat. Due = $720 → The remaining amount the Patient has to pay, for that Date of Service.
- As seen in the image, the code D3330 was checked out, resulting in a Patient Due of $1,200 and also the Patient estimate as $1,200.
- The patient then made a payment of $500 → This reduced the Pat. due to $700. (Patient Estimate is not affected by payments)
- There was a Patient Adjustment (ADJ-ON) of $20 → which results in Pat. due being increased to $720, and the Pat. Estimate increased to $1,220
- Pat. Estimate = $1,220 → The net value charged to the Patient, for that Date of Service.
- Indicates the Total patient responsibility (includes adjustments).
- This is derived by the Base Patient Estimate ($1,200.00 from D3330) plus Patient Adjustment (Patient Adj On of +$20.00).
Points to Remember
- The Pat. Due value will be affected by Code checkouts, Adjustments & Patient Payments.
- The Pat. Estimate value will be affected by Code checkouts (including MSBs: Migrated Starting Balances) & Adjustments.
- Similar logic applies to Ins. Due & Ins. Estimate values.
- If there are no dues, the value will be depicted as Pat. Due. $0.00 / $1,220.
- Your objective should be to drive the Dues down to $0.00, post which the Group will show a green icon.
Summary Footer
The bottom summary bar shows totals for Patient Due, Insurance Due and Unapplied Credits (with a direct link to Manage Credits).
Filtering
Select the 'Requires Attention' tab to view only those DOS groups that need follow-up.
You can filter results as in the normal ledger by Completed Codes, Codes linked to Payment Plan, Patient Payments, etc. Additionally, you can use the Date Range filter to narrow down your search.
Practices can use this simple guide to learn all about grouping ledger by DOS in CareStack.