Getting started:

Step 1: Select Auto-Debit Details

  • Payments: Enter the number of payments for the scheduled auto-debit or check the [Indefinite] box to have the payments go forever.

  • Amount: Enter the dollar amount - what each payment will be.
  • Start Date: Click the date to open the calendar and easily select the date the payments will begin.
  • Frequency: Select the frequency.
  • Patient Account: The menu will search for patients that match the information entered into the field. Enter the patient's first name or last name, company, patient ID, or TPS ID, then select their patient account from the menu. 
  • Add: If this is a new patient and they do not have a patient account yet, the drop-down menu will display "PATIENT NOT FOUND" if you try searching their name. Click on the [Add] button to the right to add a new account. 
    • Edit: If you have selected an existing patient, a [Edit] button will appear, allowing you to edit the patient's demographics if needed.
    • Billing Type: Select DD/Bank on File:
      • The DEFAULT billing will always display second when the patient has billing information saved as the default. You will also have the option to Add New billing by selecting [NEW EFT BANK ACCOUNT].
      • Verify the billing address & phone. For security purposes, this will be the address where the patient's bank mails their statements. For Candian offices ONLY, enter the Institution ID and the Transit # (3 digits + 5 digits). DO NOT TYPE A + SYMBOL. NO SPACES.
  • Merchant Account: The defaulted merchant account will be displayed, but if using multiple merchant accounts with us, make the correct selection here. For more information, contact our Merchant Services Department by phone at (877) 343-8950 x102) or email MerchantAccounts@CashPractice.com
  • Amount/Payment Splitter: If needing to split the payment amongst multiple family members, follow the instructions HERE 
    • [Linked]: If you need to link more patients or un-link anybody, click on the [Linked] button.
    • Note: If you are setting up an auto-debit for multiple linked patients, the moment you start typing in a dollar amount for the 2+ patients, the system will automatically start readjusting the amount for the first patient, to ensure the total always matches the [Amount] field at the top. 
  • Comments: (OPTIONAL) Leave a comment if needed. Any comments added, will not be seen by the patient.
  • Show Additional Options: (OPTIONAL) By clicking the drop-down, you have the capability to assign auto-debit groups, Drip-Education campaigns for frequent contact, Patient Groups to better organize your patient lists, and a comment
    • Patient Groups: (Optional) This allows you to group your patients based on whatever parameters you would like. You can then use this to keep track of your patients and leads and also efficiently target market. 
    • If the patient has linked patients, it will display their name with a checkbox next to it, allowing you to designate who you want to assign a Patient Group to. 
    • Drip-Ed™ Campaigns: (Optional) Requires the Drip-Education Email Marketing System™.  We highly recommend you use this feature to continue frequent contact with your patients.
    • If the patient has linked patients, it will display their name with a checkbox next to it, allowing you to designate who you want to assign a Drip-Ed™ Campaign. 
    • Select the [Start] bubble icon and choose a start date for when you want the campaign to start. If it is a birthday campaign that you are assigning, select the birthday cake bubble icon, and select [Every Year] from the drop-down menu.
    • Auto-Debit Groups™: (Optional) This allows you to categorize your payments into groups. For example, it allows you to track your Chiropractic Services, Massage Services, Products, Locations, etc. 
    • Care Plan Option: (Optional) If this Auto-Debit is for an existing care plan created with the Care Plan Calculator® System, indicate the payment option (i.e. Option 1, 2, or 3).  This will keep your stats more accurate.

Step 3:  Click the [Schedule Auto-Debit] button. Click [Ok] to proceed in the pop-up box. 

Step 4: (OPTIONAL) Capture the [e-signature] from the patient.

Step 8: Print the authorization form by clicking on the [Logo] located on the left side of the page.