> ## Documentation Index
> Fetch the complete documentation index at: https://docs.decodahealth.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Checkout & Payment Methods
> Walk through the checkout flow, choose a payment method, split payments, and manage surcharge fees.
Navigate to **Billing > Check Out** to start the checkout flow, or click **Create Charge** from the Charges table.
## Check Out a Patient
The checkout flow is a multi-step process for creating charges and collecting payment. Navigate to **Billing > Check Out** or click **Create Charge** from the Charges table.
Search for and select the patient you are billing. If the patient has existing outstanding charges, they appear automatically so you can collect on them.
If your organization has multiple locations, choose the location for this transaction. This determines which POS devices are available and which tax rules apply.
If the patient has appointments or treatments scheduled for today, the items from those visits appear automatically — along with any services or products a provider picked in a note's **Today's Items** question. Click **Add** next to any item to include it in the charge. Each item shows its price, quantity, and the provider who performed the service.
If multiple merchant accounts are configured, choose which account should process the payment.
Add items to the charge using any combination of:
* **Services & Products:** Search and add services, items, or packages. Each line item shows its price, and you can adjust quantities. Only items with **Show in Checkout** enabled appear here (see [Products](/modules/settings/products), [Medications](/modules/settings/medications), or [Packages](/modules/settings/packages) settings). By default, services and medications priced at \$0 are hidden from search and Today's Items; turn on **Show \$0 Items in Checkout** under **Settings > General** to include them.
* **Custom Amount:** Enter a one-time dollar amount with an optional description.
* **Discount:** Apply a flat dollar or percentage discount to the charge total.
* **Tip:** Add a tip amount.
* **Description:** Add a free-text description for the charge.
* **External ID:** Attach an external reference identifier.
* **Date of Service:** Override the service date if it differs from today.
* **Comment:** Add an internal comment visible only to staff.
If the patient has available discounts, memberships, packages, or banked items (pre-purchased service credits), click the **Discounts** button to open a unified panel. Use the category tabs (All, Membership, Packages, Banked) and search bar to find and apply discounts to the charge.
Each discount applied to a line item shows a small badge naming its source — **Membership**, **Package**, **Promo**, **Banked**, or **Manual** for a hand-applied discount — so you can see at a glance why a price was reduced.
Promotions can be limited to an item category. When a promotion is set up for a category, checkout also applies it to items in any category nested under it, so a promotion for an overall category can cover more specific services or products in that group.
When a credit covers a category (or otherwise matches more than one line), checkout spreads it across those items up to the number of sessions or units the credit still has. For example, a credit good for 50 units applied to one item of 89 and another of 30 covers all 50 units across the two — never more than the credit holds, and the remaining units stay at full price. The total settles to the same amount no matter the order you add the items or apply the credits, and it updates automatically as you add items or change quantities.
If the patient has outstanding charges from previous visits, you can select one or more of those charges to pay instead of (or in addition to) creating a new one.
Select how to collect payment. See [Payment Methods](#payment-methods) for details on each option.
Depending on the method chosen, either the terminal processes the card, the patient enters details in the virtual terminal, or you record the external payment. After success, the system displays a confirmation screen with options to send a receipt.
### Override an Item or Package Price
If an item or package has **Allow custom price at checkout** turned on in its settings, an edit pencil appears next to its price in the cart. Click it, enter a new amount, and click **Save Price** -- the line shows the original price struck through next to the new one. If the pencil isn't there, open the item in **Settings** ([Packages](/modules/settings/packages), [Products](/modules/settings/products), or [Medications](/modules/settings/medications)) and enable the option.
### Customer Display
During checkout, you can connect a separate customer-facing display device to show live checkout details and collect tips. Click **Connect Customer Display** in the charge step to open the device selection window, which lists available displays for your location. Each display shows its status (ready, in use, or not active). Select one and click **Connect** to start mirroring the charge details in real time.
When you reopen checkout, the last display you used is reconnected automatically if it's still online and idle. If it's offline or already in use by another checkout, no display is connected and the **Connect Customer Display** button stays visible so you can pick a different one.
When a patient picks a tip on the customer display, a **Tip Recipient** window appears on the checkout screen so you can choose which provider gets the tip. See [Collect a tip](/modules/billing/tip-screen#part-3-collect-a-tip-at-checkout) on the tip-screen page for details.
Separately, click the **Preview** button in the header to open a charge preview panel on your own screen.
### Zero-Dollar Charges
When the total amount due is \$0.00 (for example, if packages or discounts fully cover the charge), the checkout skips the payment method selection. Instead, a confirmation screen appears showing the \$0.00 total and asking you to confirm the charge. After confirmation, the charge is created and marked as complete without any payment processing.
## Payment Methods
When collecting payment at checkout, you choose from the following options. Your organization's administrator controls which methods are enabled.
Send the charge directly to a physical payment terminal (e.g., Lane 3000, Lane 7000, Link 2500) connected at the selected location.
* The terminal prompts the patient to tap, insert, or swipe their card.
* A processing screen appears while the terminal communicates with the payment processor.
* If no terminal is configured for the location, this option is disabled with a message.
Use the virtual terminal to charge a card or bank account without a physical device.
* If the patient has **saved payment methods**, they appear for selection.
* Otherwise, enter card details (number, expiration, CVC, ZIP) directly.
* Supports both debit and credit cards.
* When **ACH (bank transfer)** is turned on for your organization, a bank-transfer option appears alongside card entry. Turn it on under **Settings > Payment Management** in the **Payment methods** section. The single switch controls every payment surface — staff checkout, payment plans, memberships, pay links, booking-fee checkout, embeds, and intake-form payment methods.
* When [dual pricing](/modules/settings/general#dual-pricing) is enabled, an **Apply cash pricing (HSA/FSA)** checkbox appears on POS Terminal and Virtual Terminal payments. Tick it to charge the cash price on a card payment — useful for HSA/FSA cards. Saved ACH methods are hidden when the override is on, since ACH returns can't reverse the cash-discount adjustment.
* **How the discount is figured.** For each item, the difference between its regular price and its cash price becomes the discount. For an item where staff typed a **custom amount** (allow custom pricing items), there isn't a separate cash price to compare against, so the discount equals the card-processing fee the patient would have paid had they used a card — applied once across all custom-priced lines on the same charge.
* **How it shows on the receipt and history.** Each item in the charge breakdown gets a "Cash Discount" line so staff can see exactly which lines were reduced. The charge total in the patient's billing timeline shows the original total with a line through it and the lower amount next to it, the same way a regular discount looks.
* **Multi-charge payments.** When one payment settles several charges and they're routed to different merchant accounts, the discount on each charge is figured using that charge's own processing fee, so a mixed batch is still calculated correctly.
* **Partial cash payments.** If the patient pays only part of what they owe, the cash discount is scaled down proportionally — they get a discount on the portion they paid in cash, not the full balance. The unpaid remainder stays on the charge at the regular price, and a follow-up cash payment can discount that next slice.
* **Tips are not discounted.** Tips are always charged at the amount the patient added; the cash-pricing rules only apply to items and tax. In a multi-charge payment, the tip portion of each charge is still consumed by the payment in the normal order — staff don't need to handle it differently.
Set up a recurring payment schedule for the outstanding balance.
* Configure the **initial payment amount** (can be \$0 for zero-down plans).
* Set the **installment amount**, **number of installments**, and **frequency** (weekly, bi-weekly, monthly).
* Choose a **start date** for the first installment.
* The patient must provide a card on file for automatic future charges.
* A payment plan preview shows the full schedule before confirmation.
Create the charge and send invoices to the patient using Decoda's automated collection system.
* **Intelligent Invoicing (recommended):** Select a rule set that defines the automated sequence of SMS/email reminders, their timing, and escalation rules.
* **Manual Invoice:** Write a custom message using the rich text editor with patient variable support.
* The patient receives a payment link where they can pay online.
* The patient gets a text or email with a link. They tap it, see their balance, and pay with a credit card — no app download or account required. On a supported Apple device, an **Apple Pay** button appears at the top of the payment page so patients can pay with Face ID or Touch ID. Card and bank transfer remain available below it. To hide Apple Pay across pay links, online booking-fee checkout, and embedded payment pages, turn off the **Apple Pay** switch under **Settings > Payment Management** in the **Payment methods** section.
Record a payment made outside the system (cash, care credit, check, or other external method).
* Enter the amount received.
* The charge is marked as settled without processing a card transaction.
Apply available credit from the patient's account toward the charge.
* Shows the patient's current credit balance.
* If the patient has no credit available, this option is disabled.
* Credit is deducted from the patient's balance upon confirmation.
Paying with credit isn't a separate revenue event — it draws down a liability the clinic already owes. See [Patient Credit Accounting](/guides/patient-credit-accounting) for how spending credit shows up in reports.
Redeem the patient's loyalty points toward the charge. Appears when the [Loyalty Points](/modules/billing/loyalty-points) add-on is on and the patient has points available.
* Shows the patient's available points and their dollar value.
* Pick which batches of points to apply; the value reduces the amount due.
### Split Payments
For POS terminal, virtual terminal, and patient credit methods, you can enable **Split Payment** to collect only a portion of the total. Click **Split Payment**, enter the partial amount, and process it. The remaining balance stays outstanding for future collection.
### Surcharge Fees
If your organization has credit card surcharging enabled, an additional fee may be applied to credit card payments. The surcharge is calculated automatically based on the card type detected during checkout. Patients with surcharging disabled on their profile are exempt.