Module 5 - Money (Charges and Payments)

Module 5: Money - Products, Services, Inventory

Description

Learn how to manage products, services, inventory, and commissions across one or multiple locations. This Module covers setup, tracking, and compensation structures.

Key Topics

• Creating and managing products and services
• Inventory management (single and multi-location)
• Commission structures and configuration
• Packages and gift cards

Please note: The outlines below are intended to supplement the linked videos and are not standalone documentation.

4D EMR Onboarding 5.0 - Money (Charges and Payments) Overview (02:54)

Money (Charges and Payments) Overview

This module walks through how to set up these financial items and how they appear throughout your system.

Before we begin, here are a few important housekeeping notes.

Housekeeping Notes

Manual Entry vs. Mass Import

While you will learn how to manually add products, services, and procedures, your project manager will also review the option to mass import these items (during onboarding ONLY).

• The import is completed once per practice

• Work closely with your project manager to ensure the Google Sheet is filled out correctly

Payment Processor Integrations

Some features in this module rely on integrated payment processors.
Because new integrations are continually being developed, confirm with your project manager whether certain features apply to your processor.

Most demonstrations in this module use the 360 Payments integration.

Configure Charges Before Using Quotes

It is strongly recommended that you complete all money and charge configuration before using quotes.

This ensures that all fees and surgical items import correctly.

Navigating the Money Tab

After logging into 4D, navigate to the Money tab in the top‑right corner.

Guest Cart

If no patient is selected:

• A guest cart will load
• You can sell items to non‑patients if your database is configured to allow it

Patient Cart

Use the patient search option at the top of the page to load a patient’s account.
Once loaded, additional financial options will appear in the tiles below.

Creating a Charge

Charging a patient in 4D is straightforward:

1. Add items to the cart
2. Use the blue pencil icon to apply discounts if needed
3. Select Checkout
4. Choose the patient’s payment method
5. Complete the transaction
6. Print or email the receipt

More advanced configuration options for the Money tab will be covered later in this module.

Packages and Quotes

Patients who have:

• Purchased packages, or
• Have active quotes

…will see them listed in the Money tab.
You can review these items or collect additional payments as needed.

Searching for Items

Use the filters at the top of the Money section to search by:

• Custom search term
• Category
• Staff member providing the service

Charge Categories

4D organizes charges into four major categories:

Procedures

Surgical procedures performed by the doctor
Example: Facelift

Services

Non‑surgical services performed by doctors or staff
Example: Facials, CoolSculpting

Products

Physical items sold to the patient
Example: Garments, skincare products

Miscellaneous

Other charges such as no‑show fees

You can also combine services and products into packages that patients can purchase and use over time.

4D EMR Onboarding 5.1 -  OR Fees (01:32)

OR Fees 

Overview

Most practices perform surgical procedures at hospitals or surgery centers that charge OR (Operating Room) fees.
To ensure patients receive accurate quotes, you’ll need to configure these fees in 4D.

This section provides a quick overview.
You’ll learn the full quoting workflow in the Quoting Module.

Accessing OR Fee Settings

Navigate to:
Practice → Admin → Facilities

You should already have your hospitals and surgery centers created from a previous setup video.

To configure OR fees:

1. Select the surgery center you want to edit
2. Click the blue icon under Fee Schedule

This opens the OR Fee Calendar.

Using the OR Fee Calculator

If the surgery center keeps pricing consistent, use the built‑in calculator.

Example:

• $500 for the first hour
• $250 for each additional 30 minutes

After entering the values:

• Select Calculate
• The system will automatically compute fees for up to 15 hours
• Review the results
• Select Save at the bottom of the page

Adjusting Variable OR Fees

If the facility’s OR fees vary:

1. Still begin with the calculator to generate a baseline
2. Click into any individual fee you need to adjust
3. Manually update the time or amount to match the facility’s schedule
4. Repeat for all time blocks that differ

Be sure to review all OR fees for each hospital and surgery center to ensure accuracy.

How OR Fees Work in Quotes

When quoting a patient:

• You will select the facility from a dropdown menu
• The OR fee will automatically calculate based on the quote time

This ensures consistent, accurate quoting across your practice.

4D EMR Onboarding 5.2 - Anesthesia Fees (02:17)

Anesthesia Fees 

Overview

Most practices include anesthesia fees as part of their surgical quotes.
To ensure patients receive accurate estimates, you’ll need to configure these fees in 4D.

This section provides a quick preview.
You’ll learn the full quoting workflow in the Quoting Module.

Accessing Anesthesia Fee Settings

Navigate to:
Practice → Settings → Quotes → Anesthesia Groups

Creating an Anesthesia Group

1. Select + New to the right of Anesthesia Group
2. Give the group a name
3. Choose whether anesthesia fees will be paid separately by the patient
   • If enabled, the fee appears on the quote but does not require the practice to collect payment
4. Select which facility (or facilities) this anesthesia group services
5. Select Save

Linking Anesthesiologists

If you need to associate a specific anesthesiologist with the group:

1. Select + New next to Anesthesiologists
2. Enter the provider’s information
3. Select Save
4. Return to the anesthesia group
5. Choose the anesthesiologist from the dropdown list

Setting Up Anesthesia Fees

Select the blue rectangle icon under Fee Schedule to open the anesthesia fee calculator.

Using the Calculator for Consistent Pricing

If the anesthesia group uses consistent pricing:

• Enter the first‑hour fee
• Enter the fee for each additional time block

Example:

• $250 for the first hour
• $125 for each additional 15 minutes

Select Calculate and the system will automatically compute fees for up to 15 hours.

Review the results and select Save.

Adjusting Variable Anesthesia Fees

If the anesthesia group’s fees vary:

1. Start with the calculator to generate a baseline
2. Select any fee in the table
3. Manually adjust the time or cost to match the group’s actual schedule
4. Repeat for all time blocks that differ

Be sure to review all anesthesia fee schedules for accuracy.

How Anesthesia Fees Work in Quotes

When quoting a patient:

• Select the facility from the dropdown
  • The OR fee will calculate automatically based on procedure hours
• Select the Anesthesia Group from its dropdown
  • The anesthesia fees will calculate automatically based on the quote time

This ensures consistent, accurate quoting across your practice.

4D EMR Onboarding 5.3 - Misc. Charges and Others (05:22)

Misc. Charges and Others

Overview

Before going live, you’ll want to configure your miscellaneous charges, discount reasons, and other charge‑related settings so your database aligns with your practice’s workflow.

This section provides a quick review of the key features you’ll use to manage charges in 4D.

Running Transactions in 4D

Navigate to:
Money → Select Patient

Adding Items to the Cart

• Add the items the patient is purchasing
• Use the blue pencil icon to:
  1. Adjust quantity
  2. Apply a discount
  3. Select a discount reason

Checkout

• Select Checkout
• Choose a payment method from the left side
• Complete the transaction
• Select Complete Sale
• Print or email the receipt

Many of these elements can be customized to match your practice needs.

Configuring Charge‑Related Settings

Navigate to:
Practice → Settings → Money

This opens a menu of configurable financial options.

Custom Payment Methods

Custom payment methods allow you to add additional payment tiles for checkout.
These do not create integrations—they simply allow you to track additional payment types for reporting.

Creating a Custom Payment Method

1. Select + New
2. Assign a three‑digit code
3. Enter a name
4. Optionally assign a color using the color wheel
5. Select Save

Using the New Payment Method

• Add items to the cart
• Select Checkout
• Choose the new payment method
• Use the blue pencil to specify how much of the total this method will cover
• Apply another payment method for the remaining balance

Create as many custom payment methods as needed.
You do not need to create payment methods for integrated processors like 360 Payments.

Processing Fees

4D allows you to apply processing fees to card transactions if enabled.

When a card payment is selected, a pop‑up will notify staff that a processing fee will be added.

Configuring Processing Fees

Navigate to:
Practice → Settings → Money → Processing Fee Settings

Then:

• Toggle on Apply Processing Fee
• Enter the processing fee percentage
• Add a label
• Add the message patients will see
• Choose whether the fee applies to debit cards
• Select Save

You must log out and back in for changes to take effect.

Important: Processing fee laws vary by state. Consult legal counsel before enabling this feature.

Register Category Colors

Register categories are outlined by colored borders.
While you cannot change the categories themselves, you can change their border colors.

Navigate to:
Practice → Settings → Money → Register Categories

• Select the color box
• Choose a new color or enter an RGB/HEX code
• Save your changes

Miscellaneous Charges

Misc charges allow you to create custom fees such as:

• No‑show fees
• Surgery cancellation fees
• Administrative fees

Creating a Misc Charge

Navigate to:
Practice → Settings → Money → Miscellaneous Charges

1. Select + New
2. Name the charge
3. If it’s a flat fee, enter the Charge Amount
4. If the fee varies, enable Set Amount During Checkout
5. Select Save

Using Misc Charges

• Navigate back to Money
• Pull up a patient
• Use the category filter to find Misc Charges
• Add the charge to the cart
  • Flat fees add automatically
  • Variable fees prompt you to enter the amount

Discount Reasons

Discount reasons appear:

• When editing items in the cart
• In the quoting module

4D includes default discount reasons, but you can customize them.

Editing Discount Reasons

Navigate to:
Practice → Settings → Money → Discount Reasons

• Delete any reasons you don’t need
• Select + New to add your own
• Enter the reason
• Select the blue check mark to save

New discount reasons become available immediately.

Additional Settings

These settings are optional but helpful:

Receipt Options

• Display receipts in a uniform color
• Hide provider names on service items
• Add custom text to the bottom of receipts

Inventory Settings

Navigate to:
Practice → Settings → Money → Inventory

• Enable Manage Inventory by Location only if you have multiple locations requiring independent tracking

4D EMR Onboarding 5.4 - Creating Products (03:01)

Creating Products 

Overview

Creating and managing your product list in 4D is straightforward.
During onboarding, your initial product list will be imported based on the Google Sheet you provide.
If you have questions about completing that sheet, work closely with your project manager.

Once the initial import is complete, your practice will be responsible for adding and maintaining any new products.

This section walks through the full workflow for creating new products in your database.

Accessing the Product List

Navigate to:
Practice → Products → Product List

This is where all products used in your practice are managed.

Adding a New Product

Select + New to the right of Product List.
A new product window will appear.

Basic Product Information

Product Name

Enter the name of the product.

Manufacturer (Optional)

You may assign a manufacturer, but this requires creating your manufacturer list in a separate section.

Product Code (Required)

Most practices use a 3–4 character code, in all caps.

Category

Choose one of the five available categories:

• Garments
• Implants
• Injectables
• Products
• Surgery Items

Barcode (Optional)

Enter the product’s barcode number if applicable.

Cost of Goods

Enter the cost of goods if known.
This is highly recommended for accurate reporting.

Base Unit

Select the base unit to keep product tracking consistent.

Tax, Returns, and Procedure Linking

Taxable

Toggle on Taxable 1 or Taxable 2 if the product is subject to tax.
These reference the tax rates configured during your basic setup.

Returnable

Toggle on Returnable if the item can be returned.
Refunds and returns will be covered later in the module.

Includes a Procedure

This option links the product to a specific procedure, but it is rarely used by most practices.

Inventory Tracking

If you want to track inventory for this product:

Toggle on Inventory

A Reorder Threshold field will appear

The system will alert your practice when the product quantity drops below this threshold during sales.

We recommend setting reorder thresholds for all inventory‑tracked items.

Pricing Configuration

Pricing Name

Give the pricing entry a name.

Show in Money

Toggle on Show in Money if the product will be sold or charged to patients.
Anything used in transactions should have this enabled.

Patient‑Only Restriction

Toggle on Patient Only if the product should not be sold to guests.

Show for Quotes

Enable this if the product needs to be available during the quoting process.
This also allows the product to be linked to procedures.

Product Image

You may add a photo by:

• Dragging an image into the window, or
• Uploading it from your computer

Saving the Product

Once all fields are configured, select Save.

Your product is now active in the system and ready for use.

4D EMR Onboarding 5.5 - Creating Services (03:08)

Creating Services 

Overview

Creating and managing your services in 4D is simple.
During onboarding, your initial service list will be imported using the Google Sheet you provide.
If you have questions about completing that sheet, your project manager can assist you.

Once the initial import is complete, your practice will be responsible for adding and updating services moving forward.

Accessing the Services Section

Navigate to:
Practice → Settings → Money → Staff Services → Services

On this page, you’ll see a brief description of what should be added as a service.

Important Distinction

• Injectables by unit (e.g., Botox per unit) → Create as Products
• Injectables by area → Create as Services

Creating a New Service

Select + New next to Services.

A new service window will appear.

Service Name

Enter the name of the service.

Category

4D includes a Standard category by default.
All services will be placed here unless you create additional categories (covered later).

Default Fee

Enter the amount you charge for the service.

CPT Code (Optional)

Add a CPT code if needed.

Tax Settings

If the service is taxable:

• Toggle on Tax Rate 1 or Tax Rate 2
• These tax rates were configured during your basic setup

Commission Settings

To set up commissions:

1. Toggle on Report and Commission Item
2. Enter a default commission amount
   • Either a dollar value or a percentage

You can override these settings per staff member later.

Inventory Supplies (Optional)

If the service uses inventory items:

1. Select + New under Inventory Supplies
2. Choose any product that is set up as an inventory item
3. Enter the quantity used for the service

When the service is completed, the associated product quantity will automatically be deducted from inventory.

If the service does not require supplies, skip this section.

Staff Permissions and Overrides

Near the bottom of the page, specify who is allowed to provide the service:

• Toggle on each staff member who can perform the service
• If a staff member charges a different fee, enter it here
• You may also override the default commission for each staff member
  • If left blank, the system uses the default commission defined earlier

Saving the Service

Once all fields are configured, select Save.
Your service is now active and ready to use throughout the system.

Organizing Services into Categories

Navigate to:
Practice → Settings → Money → Staff Services → Categories

Category Management

• Standard categories are built into 4D and cannot be deleted
• You can create as many custom categories as needed

Example:
A practice may create categories such as:

• Facials
• Laser
• CoolSculpting

Creating a Category

1. Select + New
2. Enter the category name
3. Select the blue check mark to save

These categories will now appear in the category dropdown when creating or editing a service.

4D EMR Onboarding 5.6 - Creating Procedures (02:17)

Creating Procedures 

Overview

Creating and managing your surgical procedures in 4D is straightforward.
During onboarding, your initial procedure list will be imported using the Google Sheet you provide.
If you have questions about completing that sheet, your project manager can assist you.

After the initial import, your practice will be responsible for adding and maintaining any new procedures.

Before You Begin

We recommend configuring your products first.

If you plan to link products to surgical procedures—such as implants or Exparel—ensure the Show for Quotes option is enabled for those products.
This allows them to be included automatically in procedure quotes.

Accessing the Procedure Setup

Navigate to:
Practice → Admin → Doctors and Staff

To the left of the provider’s name, select the purple scalpel icon.
This opens the area where procedures are created and managed.

Creating a New Procedure

Select + New to add a new procedure.

Procedure Name

Enter the name of the procedure.

Surgeon’s Fee

Enter the surgeon’s fee for this procedure.

Facility & Anesthesia Fees

Add these fees only if they are fixed and predictable.

• If the amounts vary based on a fee schedule, do not enter them here
• Instead, manage them through the OR Fee and Anesthesia Fee schedules covered earlier in the module

Average Duration

Set the average duration of the procedure.
This can be adjusted during the quoting workflow if needed.

Optional Pricing Fields

These fields are optional but helpful:

• Estimated Total Cost
• Minimum Cost
• Maximum Cost

Setting a price range gives your front office a quick reference when patients ask about general pricing.

Staff can view this information by selecting the Price List icon on the scheduler and searching for the procedure.

Adding Supply Items

If the procedure uses specific supply items:

1. Add the required products from your inventory
2. Enter the quantity needed

When the procedure is added to a quote, these items will automatically populate with the correct quantities.

Show as Service (Rarely Used)

You can choose whether the procedure should appear as a service.
This is rarely needed, and we do not recommend enabling it unless your workflow specifically requires it.

Saving the Procedure

Once all details are entered, select Save.

Your procedure is now active and ready to use in the quoting workflow.

Summary

Creating procedures in 4D becomes quick and intuitive once you understand the workflow.
As long as you have the necessary information ready, you can log in, enter the details, and streamline your quoting process for all surgical procedures.

4D EMR Onboarding 5.7 - Packages (03:30)

Packages 

Overview

Once all of your products and services are fully configured and active in your database, you can begin creating packages.
Packages allow you to bundle multiple products and services together—often at a discounted rate—and track their redemption over time.

This section covers:

• How packages function in the Money tab
• How to redeem package items
• How to create new packages in your system

How Packages Work in the Money Tab

Accessing Packages

Navigate to the Money tab and open a patient record.
You’ll see tiles for:

• Products
• Services
• Quotes
• Packages (outlined in purple by default)

Adding a Package to the Cart

When you add a package:

1. You’ll be prompted to complete a few details
2. If the package uses a commission structure, select the staff member in the Staff for Commission dropdown
3. Enter how many items (products or services) the patient is redeeming at this visit
4. Apply discounts if needed
5. Select Save to Cart
6. Proceed to Checkout and collect payment

After Purchase

Once payment is complete:

• Return to the patient’s Money tab
• The purchased package will now appear outlined in pink, indicating it is active and ready to use

Redeeming Package Items

When the patient returns to use part of their package:

1. Select the green cart icon on the package
2. Assign commission if applicable
3. Enter the number of items being redeemed
4. Review the running history at the bottom of the window
5. Select Save to Cart
6. Complete checkout (no payment required—everything is prepaid)

Repeat this process until all items are redeemed.

Once the package is fully depleted, the tile automatically disappears.

Creating a New Package

Navigate to:
Practice → Products → Packages

Select + New to open a new configuration page.

Package Setup

Package Name

Enter the name of the package.

Commission

If the package includes a commission:

• Enter the commission amount
• Note: This applies to the sale of the entire package, not individual items

Available for Quotes (Optional)

Toggle Available for Quotes if you want the package to appear in the quoting workflow.

If enabled, you must choose whether the package becomes available:

• After the procedure is completed, or
• Immediately upon quote payment

Most practices do not use packages in quotes—consult your project manager if unsure.

Adding Items to the Package

In the second half of the page, you can add:

• Products
• Services
• Procedures (not recommended—procedure pricing is better handled through the quoting system)

Example Package

This example includes:

• Two bottles of daily cream
• Three facial services
• All at discounted rates

Adding a Product

1. Select + New next to Products
2. Choose the product
3. Enter the discounted package price (e.g., $175 instead of $200)
4. Enter the quantity (e.g., 2)
5. Verify totals
6. Select the blue check mark to save

Adding a Service

1. Select + New next to Staff Services
2. Choose the service
3. Enter the discounted package price
4. Set the quantity (e.g., 3)
5. Save

Saving the Package

Once all items are added and reviewed:

• Scroll to the top
• Select Save

Your package is now active and ready to use.

You can create as many packages as needed, as long as all required products and services already exist in your system.

4D EMR Onboarding 5.8 - Commissions (03:09)

Commissions 

Overview

Throughout this module, you’ve learned how to create products, services, procedures, and packages.
Now we’ll walk through how to fine‑tune and configure commissions for your practice.

Depending on the complexity of your commission structure, you may want to spend extra time reviewing and customizing these settings.

Step 1 — Designate Who Can Receive Commissions and Gratuity

Navigate to:
Practice → Admin → Doctors and Staff

1. Select the staff member you want to configure
2. Scroll to the bottom of the page
3. Enable the appropriate toggles:
   • Get Commissions — staff member can receive commission credit on product or service sales
   • Can Receive Gratuity — staff member is eligible for gratuities
4. If they qualify for both, enable both toggles
5. Select Save

Repeat this process for all staff members who should receive commissions and/or gratuity.

Step 2 — Configure Service Commissions

Still within Doctors and Staff:

1. Hover to the left of the staff member’s name
2. Select the syringe icon
   • This opens the list of all staff services in your database

If you’re onboarding:

• Default commission rates may have been imported from your Google Sheet
• Toggle on all services the staff member can provide

Adjusting Staff‑Specific Settings

For each service:

• If the staff member charges a different fee, update the fee field
• If their commission rate differs from the default, update the commission field
  • Enter either a dollar amount or a percentage

Repeat this process for each staff member who provides services.

This completes your service commission configuration.

Step 3 — Configure Product Commissions

If you’re onboarding, product commission defaults may already be imported.

If no adjustments are needed, you can skip this section.

Navigate to:
Practice → Products → Product List

1. Select the product you want to update
2. Scroll to the Price Options section

Setting Commission for a Product

If you have one standard price with a universal commission:

1. Select the Price Name to open the Price Settings window
2. Toggle Commission / Report Item
3. Enter the commission as either:
   • A dollar amount, or
   • A percentage

If your practice deducts cost of goods before calculating commissions, 4D includes a report for this (covered in the Reporting module).

Select OK, then Save at the top of the page.

Your product commissions are now configured.

How Commissions Work in the Money Tab

Once product and service commissions are set:

• During checkout, 4D will prompt you to select who receives commission credit
• Choose the staff member from the dropdown at the time of sale

If your practice uses role‑based or tenure‑based commission structures, refer to the Advanced Product Commission Setup video (if applicable).

4D EMR Onboarding 5.9 - Advanced Commissions (03:09)

Advanced Commissions 

Overview

Some practices use role‑based or tenure‑based commission structures for products.
4D can accommodate these more complex setups through advanced configuration.

This section builds on the previous Product Commissions video and demonstrates how to configure multiple price points and commission structures for a single product.

Training Example

In this example, we have an injectable product with three different prices and three different commission structures:

• Doctor:
  • Charges $20 per unit
  • No commission
• Tier 1 Nurses:
  • Charge $20 per unit
  • Receive 20% commission
• Tier 2 Nurses:
  • Charge $15 per unit
  • Receive $1.50 per unit commission

This is a complex structure, but 4D can support it with multiple price options.

Step 1 — Open the Product

Navigate to:
Practice → Products → Product List

1. Select the product you want to update
2. Scroll to the Price Options section
3. You should see one price imported from your onboarding Google Sheet

Step 2 — Configure the Doctor Price

1. Select the existing Standard Price under the Name column
2. Rename it to Doctor Price

Since the doctor does not receive commissions:

• You may simply select OK, or
• If you want to track sales volume, toggle Commission / Report Item and set the commission amount to $0

This records sales without calculating commissions.

Select OK.

Step 3 — Configure Tier 1 Nurse Pricing

1. Select + New next to Price Options
2. Name the price option N1 Price
3. Set the price to $20
4. Toggle on:
   • Show in Money
   • Can be sold to patients
5. Toggle Commission / Report Item
6. Enter 20% in the Percentage of Total field
7. Select OK

Tier 1 pricing and commissions are now configured.

Step 4 — Configure Tier 2 Nurse Pricing

1. Select + New next to Price Options
2. Name the price option N2 Price
3. Set the price to $15
4. Toggle Show in Money
5. Toggle Commission / Report Item
6. Enter $1.50 in the Fixed Dollar Amount field
7. Select OK

Finally, select Save at the top of the product page.

Step 5 — Demo: How It Works in the Money Tab

Navigate to the Money tab and open a test patient.

1. Filter and locate the product
2. Select the green cart icon
3. A window will appear asking which price option to use

You will now see:

• Doctor Price
• N1 Price
• N2 Price

Selecting N2 Price

• Charges $15 per unit
• Records $1.50 per unit commission

Selecting N1 Price

• Charges $20 per unit
• Records 20% commission

This allows staff to choose the correct pricing and commission structure at checkout.

4D EMR Onboarding 5.10 - Money Tab (02:18)

Money Tab 

Overview

Throughout onboarding, you’ve likely run several test transactions for your test patients.
This section reviews where those transactions live inside the patient’s account and how to navigate the Money tab effectively.

Before reviewing financial records, we’ll walk through one more example transaction to provide fresh data.

Running a Sample Transaction

For this example, the test patient had an appointment earlier today.

Accessing the Patient’s Cart

• Right‑click the patient’s appointment block
• Select Go to Money
• This opens the patient’s shopping cart

Charging the Patient

1. Locate the garment
2. Select the green cart icon
3. Select Checkout
4. Choose Cash as the payment method
5. Since the patient doesn’t want a receipt, select Close

The Money tab will reload with updated information.

Navigating the Money Tab

At the top of the page, you’ll see several key sections related to the patient’s financial activity.

Sales (Default View)

• This is where you charge patients
• All active cart and checkout actions occur here

Receipts

• Displays all receipts tied to the patient’s account
• Useful for reviewing past transactions

All View

• Shows transactions for every patient
• Sorted with the most recent at the top

Commissions

If commissions are configured:

• This tab displays recent commission entries
• It does not calculate full commissions
• It is helpful for confirming that commission credit is assigned to the correct staff member

Additional Financial Tools

Stored Cards

If integrated with a qualified payment processor:

• Selecting Credit Card allows you to securely store a patient’s card on file
• Makes future payments fast and convenient

Reward Plan

• Toggle on the Member box to enroll a patient
• A star icon will appear on the schedule and in the patient’s account
• Helps staff quickly identify reward members

Gift Cards

• The Gift Card tab shows all gift cards in the system
• Covered in detail in the Gift Cards video

Recurring Payments

If using a qualified payment processor:

• You can create recurring payments for memberships or ongoing payment plans
• Covered in depth in the Recurring Payments video

Package

• View all packages purchased by the patient
• Filter by individual patient or by all patients

Payment Requests

If integrated with a qualified payment processor:

• You can send payment requests directly to patients
• Patients receive a text or email with a link to pay from their device
• Covered further in the Payment Request video

4D EMR Onboarding 5.11 - Patient Financials (03:06)

Patient Financials

Overview

Now that you’ve learned the Money tab, it’s time to explore the Patient Financials section—your central hub for viewing and managing all financial information tied to a patient.

Navigate to:
Patients → Select Patient → Financials Dropdown

This menu contains multiple tools for reviewing balances, issuing credits, processing adjustments, and managing financial history.

(Insurance Ledger and insurance‑related tools will be covered separately in the Insurance module.)

Patient Ledger

At the top of the Ledger, you’ll see several financial categories:

Open Charges

Unpaid charges the patient still owes.

Prepayments

Payments the patient has made that are applied toward a quote.

Credits

Created when:

• You issue a credit manually, or
• A patient chooses to keep refunded money on their account

Gift Cards

Displays the patient’s current gift card balance.

The system automatically adds these categories together to calculate the patient’s overall balance.

Ledger Details

The Ledger displays all transactions the patient has had with your practice, including:

• Charges
• Payments
• Running balance
• PDF versions of receipts

Select the arrow icon to the left of any transaction to expand additional details.

You can also add notes using the blue pencil icon.

The Ledger is an essential tool for verifying transaction history and ensuring balances are accurate.

Issuing Credits

Navigate to:
Financials Dropdown → Issue Credit

We recommend using this feature only in two scenarios:

1. Migrating from a Previous EMR

If a patient has a credit balance in your old system that cannot be imported:

• Enter the credit amount
• Add a note (e.g., “Transfer credit from previous EMR”)
• Select the date and office
• Save

This ensures the patient’s balance carries over correctly.

2. Referral Promotions

For example, if your practice offers a $25 referral credit:

• Enter $25
• Add a note indicating it is a referral credit
• Select the date and office
• Save

Important

Do not use Issue Credit for any other purpose. Improper use can negatively impact your financial reporting.

Refunds, Price Adjustments, and Returns

Also found under the Financials dropdown:

• Refunds
• Price Adjustments
• Returns

These workflows are covered in detail in the Refunds and Returns training video.

Void or Update Receipts

This tool allows you to correct mistakes on recent transactions.

You can:

• Void a transaction created in error
• Update the patient if the wrong patient was charged
• Update the location if the wrong office was selected

These updates can be made within 10 hours of the original sale.

4D EMR Onboarding 5.12 - Refund Products and Services (03:02)

Refund Products and Services 

Overview

This section covers how to process:

• Product returns
• Refunds
• Price adjustments

Refunds and returns in 4D always follow a two‑step workflow, but the steps differ slightly depending on whether the item is returnable.

Part 1 — Returning a Product (Returnable Items)

Prerequisite — Ensure the Product Is Returnable

Before processing returns, the product must be configured correctly.

Navigate to:
Practice → Products → Product List

1. Select the product
2. Scroll to the Returnable checkbox
3. Toggle it on
4. Select Save

Step 1 — Accept the Return

Navigate to:
Patients → Select Patient → Financials Dropdown → Accept Returns

If the patient has purchased a returnable item, it will appear on this page.

1. Under Returning Now, enter the quantity being returned
2. Choose whether the item should be added back into inventory
3. Select the blue check mark
4. Select Credit to Account

You’ll be taken to the patient’s Ledger, where the credit will now appear.

The patient may keep this credit for future use—but in this example, they want a full refund.

Step 2 — Process the Refund

Navigate to:
Financials → Create Refund

1. Locate the credited product
2. Select the Balance Total to populate the refund amount
3. Select Refund
4. Choose the refund method
   • If using a qualified payment processor and the patient has a card on file, it will appear as an option
   • You can refund directly back to that card
5. Finalize the refund and provide a receipt if needed

This completes the workflow for returnable items.

Part 2 — Refunding a Service or Non‑Returnable Item

Services cannot be returned, so the workflow begins with a price adjustment.

Training Scenario Example

A patient received a facial and had an allergic reaction.
The practice chooses to refund the service.

Step 1 — Adjust the Price

Navigate to:
Financials Dropdown → Price Adjustment

1. Locate the eligible transaction (the facial)
2. Enter the full cost of the service in the Price Adjustment field
3. The new unit price will update to $0.00
4. Select the blue check mark
5. Select Credit to Account

This creates the credit needed to process the refund.

Step 2 — Process the Refund

Navigate to:
Financials → Create Refund

1. Locate the price adjustment entry
2. Select the Balance to populate the refund amount
3. Select the blue check mark
4. Choose Refund
5. Select the appropriate payment method
6. Complete the transaction

Summary — The Two‑Step Workflow

For Returnable Products

1. Accept Return → Credit to Account
2. Create Refund → Issue Refund

For Services or Non‑Returnable Items

1. Price Adjustment → Credit to Account
2. Create Refund → Issue Refund

This consistent structure ensures accurate financial reporting and clean patient account histories.

4D EMR Onboarding 5.13 - Recurring and Payment Requests (03:30)

Recurring and Payment Requests

Overview

If your practice integrates with one of 4D’s qualified payment processors, you can enable two powerful financial tools:

• Recurring Payments — automated payment plans that collect payments on a set schedule
• Payment Requests — invoices sent by text or email so patients can pay from their device

This section walks through how to configure recurring payments and how to send payment requests using the 360 Payments integration.

Recurring Payments

Accessing Recurring Payments

Navigate to:
Money → Select Patient

Near the top of the page, you’ll see the Recurring Payments button with a dropdown:

• Plans — create and view payment plans
• Installments — view the status of individual installments

Creating a New Recurring Payment Plan

1. Select Plans
2. Select + New to open the new plan window
3. Choose the patient who will be on the plan

Add a Payment Card

• If the patient already has a card on file, select it
• Otherwise, add a new card and save it

Configure Plan Details

• Enter a plan title
• Add a note (optional)
• At this time, recurring payments can only apply to the Unspecified Prepayments category
• Select the office
• Enter the monthly payment amount
• Choose the start date
• Enter the number of installments
  • Example: A 12‑month plan = 12 installments

A payment calendar will display the scheduled collection dates.

Select Save when finished.

How Recurring Payments Work

Once saved:

• The plan appears in the patient’s Recurring Payments list
• 4D automatically processes each installment
• Each payment posts as an Unspecified Prepayment on the patient’s account

Viewing Installments

Navigate to:
Recurring Payments → Installments

You can:

• Filter by past, current, or future installments
• View all patients or just the selected patient
• Manually charge an installment if the patient wants to pay early

Using the Prepayment

After each recurring payment is collected, it appears as a credit in the Money tab.

To apply it:

1. Add the item to the cart (e.g., monthly Botox units)
2. Select Checkout
3. Choose the prepayment as the payment method

This completes the recurring payment workflow.

Payment Requests

Overview

Payment requests allow you to send a secure payment link to a patient via:

• Email
• Text message

Patients can pay from their phone, tablet, or computer.

Work with your project manager to ensure this feature is properly configured.

Sending a Payment Request

1. Add items to the patient’s cart in the Money tab
2. Beneath Checkout, select Payment Request
3. Choose Email or Text
4. Select Send

The patient receives a link to pay their balance.
Once completed, the transaction appears in 4D and payment is collected.

Viewing Payment Request Status

Select the Payment Request button in the Money tab to review:

• Pending requests
• Completed payments
• Failed or expired requests

Important Notes

• Recurring payments and payment requests are available only with certain integrated payment processors
• Work with your project manager to configure these features according to your practice needs

4D EMR Onboarding 5.14 - Gift Cards (02:10)

Gift Cards 

Overview

Gift cards are a helpful and flexible tool in 4D, allowing patients to purchase stored value that can be used for future services or products.
Gift cards are not enabled by default, so let your project manager know if you’d like this feature activated during onboarding.

This section explains how to create, manage, reload, and redeem gift cards in the Money tab.

Creating a Gift Card

Accessing Gift Cards

Navigate to the Money tab with a patient pulled up.

Adding a New Gift Card

1. Filter for Gift Cards
2. Select the green card icon on the New Gift Card tile
3. Enter:
   • Gift card name
   • Dollar amount to load
   • Optional note

Assigning a Gift Card Number

We strongly recommend assigning a gift card number.
This makes searching and managing gift cards much easier.

If your practice uses physical gift cards, match the number to the one printed on the card.

Select OK when finished.

Completing the Transaction

• Select Checkout
• Choose the patient’s payment method
• Finalize the sale

The patient now has an active gift card balance on their account.

Viewing Gift Card Details

Select the Gift Cards button in the Money tab to view:

• Current balance
• Gift card number
• Notes
• All gift cards associated with the patient

You can also search for gift cards using:

• Patient information
• Gift card number

Redeeming a Gift Card

When a patient wants to use their gift card:

1. Add items to the cart as usual
2. Select Checkout
3. Choose the gift card as the payment method

You can also select Apply Gift Card and search by card number if needed.

Reloading a Gift Card

Patients can reload an existing gift card at any time.

1. Select the green card icon on the active gift card
2. Enter the reload amount
3. Select OK
4. Complete the checkout workflow

The balance will update automatically.

4D EMR Onboarding 5.15 - Single Location Inventory (00:59)

Single Location Inventory 

Overview

Once your products are fully configured, you can begin managing inventory in 4D.
We strongly recommend waiting until the day before go‑live to update inventory so your counts are accurate on launch day.

This section walks through how to update inventory for practices operating out of a single location.

Accessing Inventory Management

Navigate to:
Practice → Products → Inventory Update

This opens the inventory management screen.

Selecting Inventory Update Details

Before adjusting quantities:

1. Select the date you are modifying inventory
2. Choose the event type (e.g., adjustment, restock, correction)
3. Indicate whether you are adding or subtracting inventory

Updating Inventory Counts

A list of all inventory‑tracked products will appear.

You can:

• Use filters to narrow down the list
• Scroll through items manually

Under the Change column:

1. Enter the quantity you are adding or removing
2. The system will automatically display the new count to the right

Repeat this process for each product until all inventory values are updated.

Saving Your Updates

Once all adjustments are complete:

• Select Save at the top of the page

Your inventory is now updated for your single location.

Multiple Location Inventory

If your practice manages inventory across more than one location, be sure to watch the Inventory at Multiple Locations video for the correct workflow.

4D EMR Onboarding 5.16 - Multiple Location Inventory (02:08)

Multiple Location Inventory 

Overview

Some practices operate across multiple locations and need to manage inventory separately for each site.
This section walks through how to configure and maintain multi‑location inventory in 4D.

If your practice manages inventory at only one location, you can skip this module.

Step 1 — Confirm All Locations Are Set Up

Before enabling multi‑location inventory, ensure all practice locations are already configured in your database.
This should have been completed during the Basic Setup module.

Step 2 — Enable Inventory by Location

Navigate to:
Practice → Settings → Money → Inventory

• Toggle on Inventory by Location
• Select Save

Your database is now configured to track inventory separately for each location.

Step 3 — Assign Products to Locations

Navigate to:
Practice → Products → Product List

1. Select any product

2. Scroll to the Product Locations section
3. Activate the locations where this product is carried
4. Set the Alert Quantity (reorder threshold) for each location
   • This notifies staff when stock is running low
5. If the product needs to be available for outside facilities, toggle on Use for Outside Facilities
6. Select the blue check mark, then Save

Repeat this process for every product that is stocked at multiple locations.

Step 4 — Updating Inventory by Location

Navigate to:
Practice → Products → Inventory Update

This is where you update inventory counts for each location.

Updating Stock

1. Select the date of the inventory adjustment
2. Choose whether you are adding or reducing stock in the Event field
3. Select the location you want to update
4. View all products for that location or filter for a specific item
5. Under the Change column, enter the quantity being added or removed
6. Repeat for all items at that location
7. Select Save at the top of the page

Repeat this process for each location as needed.