Family medicine clinic

Birchcombe Commons Family Medicine · Family medicine clinic · Duluth, MN

Hollis Jablonski manages the practice at Birchcombe Commons Family Medicine, a Duluth primary care clinic with three clinicians, and she uses this to bill each visit, collect signed financial agreements and chase what patients still owe.

Healthcare BillingDocuments and e-sign5 tables · 8 views · 2 forms · 1 dimension set · 1 dashboard · 1 digest · 1 document · 1 notification · 1 stage rule set · 1 agent

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Billing board

Visit bills

Draft3

VB-60152Evander Mkhize-HoltEstablished patient visit, brief

VB-60173Anneliese DragomirBlood draw

VB-60224Ignatius OkparaekeEstablished patient visit, standard

Sent7

VB-60116Wilhelmina Strandberg-OseiAnnual physical

VB-60125Casimir OdenkirkEstablished patient visit, brief

VB-60158Fenella HaverstockStrep test

VB-60164Lazlo PettiboneEstablished patient visit, brief

VB-60194Percival Nakagawa-DunnEstablished patient visit, brief

2 more

Partly paid4

VB-60146Evander Mkhize-HoltEstablished patient visit, extended

VB-60149Evander Mkhize-HoltEstablished patient visit, standard

VB-60185Soledad Achebe-LindqvistEstablished patient visit, extended

VB-60200Olumide Brightmoor-ReyesBlood draw

Overdue8

VB-60119Casimir OdenkirkEstablished patient visit, standard

VB-60122Casimir OdenkirkStrep test

VB-60131Thandiwe Ellsworth-KerrEstablished patient visit, standard

VB-60134Bertrand LaghariEstablished patient visit, extended

VB-60137Bertrand LaghariBlood draw

3 more

Paid18

VB-60110Wilhelmina Strandberg-OseiEstablished patient visit, standard

VB-60113Wilhelmina Strandberg-OseiFlu shot

VB-60128Thandiwe Ellsworth-KerrNew patient visit

VB-60140Ysolde Marchetti-KwanAnnual physical

VB-60143Ysolde Marchetti-KwanFlu shot

13 more

Tables

Visit bills

40 sample rows · 16 columns

Each visit billed to a patient: the charge, what the insurer pays, what the patient has paid and what is left.

Bill number	Patient	Service	Seen by	Visit date	Charge	Insurance portion
VB-60224	Ignatius Okparaeke	Established patient visit, standard	Rosamund Achterholt	Oct 18, 2026	$148	$104
VB-60173	Anneliese Dragomir	Blood draw	Kwabena Linthicum	Oct 17, 2026	$29	$26
VB-60152	Evander Mkhize-Holt	Established patient visit, brief	Kwabena Linthicum	Oct 16, 2026	$96	$67
VB-60212	Leocadio Fairbairn-Osei	Flu shot	Kwabena Linthicum	Oct 14, 2026	$42	$38
VB-60125	Casimir Odenkirk	Established patient visit, brief	Kwabena Linthicum	Oct 13, 2026	$96	$67
VB-60194	Percival Nakagawa-Dunn	Established patient visit, brief	Kwabena Linthicum	Oct 11, 2026	$96	$77
VB-60143	Ysolde Marchetti-Kwan	Flu shot	Rosamund Achterholt	Oct 9, 2026	$42	$38
VB-60116	Wilhelmina Strandberg-Osei	Annual physical	Rosamund Achterholt	Oct 6, 2026	$265	$212
VB-60158	Fenella Haverstock	Strep test	Thaddeus Mbeki-Lund	Oct 3, 2026	$38	$34
VB-60206	Rosalind Verhoeven	Strep test	Rosamund Achterholt	Sep 30, 2026	$38	$34
VB-60164	Lazlo Pettibone	Established patient visit, brief	Rosamund Achterholt	Sep 28, 2026	$96	$0
VB-60218	Imogen Castellanos-Roy	Established patient visit, brief	Thaddeus Mbeki-Lund	Sep 26, 2026	$96	$72

28 more rows

Patients

18 sample rows · 9 columns

The people the clinic sees, how they are covered and what they owe across their bills.

Patient	Date of birth	Phone	Email	Coverage	Member id	Patient status
Anneliese Dragomir	Aug 19, 1965	(218) 555-0109	anneliese.dragomir@lakeheadpostalbox.net	Superior Health Alliance	SHA9013356	Active
Bertrand Laghari	Jan 9, 1971	(218) 555-0104	bertrand.laghari@lakeheadpostalbox.net	Self-pay	—	Active
Casimir Odenkirk	Nov 2, 1983	(218) 555-0102	casimir.odenkirk@lakeheadpostalbox.net	Lakehead Mutual	LMU2290815	Active
Cordelia Vasquez-Hale	Mar 6, 2004	(218) 555-0118	cordelia.vasquez@lakeheadpostalbox.net	Superior Health Alliance	SHA3321970	Active
Evander Mkhize-Holt	Dec 21, 1949	(218) 555-0106	evander.mkhize@lakeheadpostalbox.net	Lakehead Mutual	LMU7710096	Active
Fenella Haverstock	Mar 14, 1988	(218) 555-0107	fenella.haverstock@lakeheadpostalbox.net	Arrowhead Care Plan	ACP3350871	Active
Ignatius Okparaeke	Jul 12, 1962	(218) 555-0117	ignatius.okparaeke@lakeheadpostalbox.net	Lakehead Mutual	LMU8837451	Active
Imogen Castellanos-Roy	Jan 31, 1986	(218) 555-0116	imogen.castellanos@lakeheadpostalbox.net	Arrowhead Care Plan	ACP6639208	Active
Jorund Whitcombe	Feb 11, 2008	(218) 555-0110	jorund.whitcombe@lakeheadpostalbox.net	Lakehead Mutual	LMU4458120	Active
Lazlo Pettibone	Jun 5, 1976	(218) 555-0108	lazlo.pettibone@lakeheadpostalbox.net	Self-pay	—	Active
Leocadio Fairbairn-Osei	Apr 22, 1997	(218) 555-0115	leocadio.fairbairn@lakeheadpostalbox.net	Superior Health Alliance	SHA7045829	Active
Olumide Brightmoor-Reyes	Dec 15, 1980	(218) 555-0113	olumide.brightmoor@lakeheadpostalbox.net	Self-pay	—	Active

6 more rows

Financial agreements

10 sample rows · 13 columns

What each patient has agreed to about paying their share, with the bills raised under it.

Agreement	Patient	Kind of agreement	Most paid in a month	Signature	Signed on	Covers visits from
Brightmoor-Reyes: self-pay terms	Olumide Brightmoor-Reyes	Self-pay terms	—	Sent	—	—
Castellanos-Roy: financial policy	Imogen Castellanos-Roy	Standard financial policy	—	Signed	Aug 12, 2026	Aug 15, 2026
Dragomir: financial policy	Anneliese Dragomir	Standard financial policy	—	Signed	Jul 20, 2026	Jul 23, 2026
Laghari: self-pay terms	Bertrand Laghari	Self-pay terms	—	Signed	Aug 1, 2026	Aug 4, 2026
Mkhize-Holt: installment terms	Evander Mkhize-Holt	Installment terms	$200	Signed	Aug 3, 2026	Aug 6, 2026
Nakagawa-Dunn: financial policy	Percival Nakagawa-Dunn	Standard financial policy	—	Signed	Aug 7, 2026	Aug 10, 2026
Odenkirk: installment terms	Casimir Odenkirk	Installment terms	$250	Signed	Jul 16, 2026	Jul 19, 2026
Okparaeke: financial policy	Ignatius Okparaeke	Standard financial policy	—	Sent	—	—
Pettibone: installment terms	Lazlo Pettibone	Installment terms	$150	Sent	—	—
Strandberg-Osei: financial policy	Wilhelmina Strandberg-Osei	Standard financial policy	—	Signed	Jul 8, 2026	Jul 11, 2026

Fee schedule

9 sample rows · 4 columns

What the clinic charges for each kind of visit, shot and test.

Service	Code	Category	Fee
Established patient visit, brief	BC-101	Office visit	$96
Established patient visit, standard	BC-102	Office visit	$148
Established patient visit, extended	BC-103	Office visit	$212
New patient visit	BC-110	Office visit	$235
Annual physical	BC-120	Preventive	$265
School or sports physical	BC-121	Preventive	$85
Flu shot	BC-130	Shots and tests	$42
Strep test	BC-131	Shots and tests	$38
Blood draw	BC-132	Shots and tests	$29

Also included

Financial agreementDocumentWhat a patient signs to say how they will pay the part insurance does not cover.
Billing boardStage rules
Monday overdue listDigest
Bill overdueNotificationTells billing the day a bill passes its due date unpaid.

Occupational therapy clinicNorthwick Junction Occupational Therapy4 tables · 5 views · 2 forms · 1 dimension set · 1 dashboard · 1 drill-down · 1 notification · 1 stage rule set · 1 agentDrill-down

NT-20403	—	$95
NT-20406	—	$95
NT-20409	—	$110
NT-20412	—	$95

MD-5101	—	CBC and lipid panel
MD-5102	—	Routine metabolic panel
MD-5103	—	Urine and blood culture
MD-5104	—	INR and coagulation

Evaluation, visit 1: Hollis Tengelsen	NJ-40101	Evaluation
Hand therapy, visit 2: Hollis Tengelsen	NJ-40102	Hand therapy
Hand therapy, visit 3: Hollis Tengelsen	NJ-40103	Hand therapy
Hand therapy, visit 4: Hollis Tengelsen	NJ-40104	Hand therapy

LH-30404	$165	—
LH-30406	$165	—
LH-30410	$95	—
LH-30412	$165	—

Delacroix-Munn — Biscotti, dental	Dental	—
Bellweather — Tank, sick visit	Sick visit	—
Thackwell — Sir Humphrey, sick visit	Sick visit	—
Gutierrez — Chorizo, urgent care	Urgent care	—

DJ-60101	Draft	—
DJ-60108	Draft	—
DJ-60115	Draft	—
DJ-60122	Sent	—

Billing board

Tables

Visit bills

Patients

Financial agreements

Fee schedule

Also included

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