---
title: "Advance Transaction"
description: "How to collect advance payments from patients against an open encounter before the final bill is generated."
date: 2026-07-19
lastModified: 2026-07-25
category: "billing"
author: "Dr. Umesh Bilagi"
beta: false
---

## Overview

An advance is a payment received from a patient before the final invoice is generated for an encounter. It is stored as a RECEIPT voucher and is automatically counted toward the encounter's balance.

Advances are **encounter-scoped** — they belong to a specific encounter and cannot be transferred or adjusted across encounters.

## When to Use an Advance

- A patient is admitted (IPD) and pays a deposit upfront.
- A patient is registered (OPD) and pre-pays for an expected procedure.
- A TPA/insurance patient can also pay an advance — hospitals often collect advances from TPA patients as a safeguard since TPA payments can be unreliable.
- At discharge, if the TPA settles the bill, the excess advance is returned to the patient via **Return Payment**. This is a healthcare business policy — check your organization's practice.

## Collecting an Advance

1. Go to the **Patient Billing** page for the patient.
2. Click **Collect Advance**.
3. Fill in:

| Field | Required | Description |
|-------|----------|-------------|
| **Date** | Yes | Date the advance was received |
| **Resource Account** | Yes | The account receiving the money — CASH, BANK, or DIGITAL |
| **Notes** | No | Defaults to "Advance". Add a cheque number, UPI ID, or other reference here. |
| **Amount** | Yes | The advance amount received |

4. Click **Submit**.
5. A receipt is generated. Click **Print** to give the patient a copy.

The advance is automatically linked to the patient's current open (in-progress) encounter. It immediately reflects in the encounter balance.

## How Advances Settle Against Bills

There is no separate "adjustment" step. The system tracks the encounter balance using standard voucher arithmetic:

- **Total Debits (Dr):** Sum of all invoices against the encounter
- **Total Credits (Cr):** Sum of all receipts (including advances) against the encounter
- **Balance:** Dr − Cr — a positive balance means the patient still owes money

When you create an invoice for the same encounter, the advance already reduces the balance. No manual linking is needed.

## Returning Excess Money

If an advance exceeds the final bill for an encounter, the excess **cannot** be moved to a different encounter. You must:

1. Return the excess via **Patient Billing > Return Payment**. This creates a PAYMENT voucher.
2. If another encounter is due, collect a fresh advance against that encounter.

## How Advances Differ from Regular Receipts

| | Advance | Regular Receipt |
|---|---|---|
| **When used** | Before the bill is generated | After the bill is generated |
| **Invoice mapping** | No — applies to the encounter balance | Yes — can map to a specific invoice within the encounter |
| **Access** | Patient Billing > Collect Advance | Patient Billing > Receive Payment |
| **Voucher type** | RECEIPT | RECEIPT |
| **Print options** | Basic print | Supports multiple letter pad headers |

Both are auto-targeted to the in-progress encounter and both create RECEIPT vouchers. The key difference: advances are for pre-billing deposits, regular receipts can be mapped to a specific invoice.

## FAQ

**Q: Can I collect an advance for a TPA/insurance patient?**
A: Yes. Hospitals often collect advances from TPA patients because TPA payments can be unreliable. At discharge, if the TPA settles the bill, the excess advance is returned to the patient via **Return Payment**. This is an organizational policy — follow your hospital's practice.

**Q: An advance from encounter A has extra money. Can I apply it to encounter B?**
A: No. Advances are tied to the encounter. Return the excess from encounter A, then collect a fresh advance for encounter B.

**Q: Can one advance be split across multiple bills?**
A: Not explicitly. All receipts and invoices for an encounter are pooled — the balance is what matters, not individual vouchers.

**Q: How do I see outstanding advances?**
A: The encounter balance on the Patient Billing page shows the net (Dr − Cr) for each encounter. A negative balance means the patient has paid more than billed.

**Q: Can I edit or cancel an advance after submitting?**
A: Voucher editing is restricted to **admins only** as a fraud-prevention measure. If you are not an admin and need to correct an advance, do not edit the original — instead, create a **Return Payment** voucher for the same encounter. This reverses the amount and preserves a clear audit trail.