> ## Documentation Index
> Fetch the complete documentation index at: https://docs.athelas.com/llms.txt
> Use this file to discover all available pages before exploring further.

# How to Set Up Miscellaneous Line Item Charges

> Create custom line-item charge types and charge a patient for them from their profile.

### At a Glance

Line item charges are separate from insurance payments — for example, charging a patient for an injected substance that insurance won't cover.

<Note>
  This feature may be restricted to Administrators and Billing Managers at your practice.
</Note>

### Create a Line Item

In the **General** tab of [PR Settings](/insights_front_desk/patient_responsibility/pr_settings), scroll to **Custom Payment Types**. Active items appear in the line-item list when charging patients. Click **+** to create one, fill in the fields, and click **Create**.

Use the **Type** designation so the line item reports correctly:

* **Standard** — independent of your self-pay fee schedule and insurance PR; use for most transactions.
* **Add Credits** — adds flexible credits to the patient's account.
* **Self Pay** — generates self-pay PR (like a deposit applied to future self-pay PR per your self-pay fee schedule).

### Charge a Patient for a Line Item

Open the patient's profile and, on the **Charges** tab, click **+ Miscellaneous Charge**.

<Warning>
  From this window you **cannot** collect an outstanding balance (use **Pay Balance** on the profile) or copay/coinsurance/deductible (use the [Appointments](https://insights.athelas.com/appointments) page). It creates a **payment and a matching charge**, and does not pay off an existing balance.
</Warning>

Fill in the facility and provider, then add your line item — its default charge auto-fills the **Unit Price**. If the patient has available credits, you can apply them (see the **Credit breakdown**). Choose how to process or request payment, click **Confirm**, confirm again, then optionally print or send a receipt.

<Tip>
  ✨**Smart Tip:** You can create a line item on the fly at the bottom of the list in this popup, but it won't have a default charge — so prefer creating line items in **PR Settings** to keep amounts consistent across staff.
</Tip>

### FAQ

<Accordion title="Why doesn't a miscellaneous charge pay off the patient's balance?">
  A miscellaneous charge creates a brand-new payment and charge. To collect an existing balance, use **Pay Balance** on the patient's profile instead.
</Accordion>