In Instinct EMR, with Cubex Billing enabled, items dispensed from the Cubex cabinet drive invoice charges—not treatment completions. This article covers how invoice capture, profile overrides, returns, and wasted medications work.
Note: The features in this article require Cubex Billing to be enabled for your practice. Contact your practice’s admin team or Instinct Support to confirm your practice's configuration.
How invoice capture works
With Cubex Billing enabled, charges for mapped products are added to the Instinct invoice when the item is dispensed from the Cubex cabinet.
Key details:
Items must be set to Billable in MyCubex to appear on Instinct EMR invoices, regardless of their billable/non-billable status in Instinct EMR.
Each invoice line item defaults to the provider assigned to the patient's visit.
The invoiced quantity reflects what was actually removed from the cabinet—not the Instinct EMR order quantity. If there's a discrepancy, update the order quantity in Instinct EMR separately.
The Show History audit displays who issued the product, provided Instinct EMR recognizes their user ID.
If an open invoice exists for the patient, items are automatically added to it. If no active visit or open invoice exists, a new one is created.
Profile Override
A profile override occurs when an item is removed from the Cubex cabinet without a corresponding Instinct EMR order. This action requires the Profile Override user permission in MyCubex.
When an item is dispensed as a profile override:
A line item with the Cubex icon is created on the patient's Instinct EMR invoice at the exact date and time of dispensing.
If multiple Instinct products are mapped to the same cabinet item, the product that appears first alphabetically is added to the invoice.
The line item history shows which staff member issued the product, provided Instinct EMR recognizes their user ID.
Profile overrides do not create a treatment on the Tx Sheet—they only appear on the invoice.
Returns
When an item dispensed from the Cubex cabinet is returned, the invoice adjusts automatically to reflect the returned quantity.
Partial return: The invoice line item updates to reflect the amount returned, so the client is only charged for the quantity used.
Full return: The invoice line item is voided, and all charges are removed.
The complete dispensing and return history is visible on the invoice line item, including staff, date, and time details.
Wasted medications
How waste is handled on the invoice depends on your MyCubex settings. Go to MyCubex → ⚙️ → Settings → Purchasing & Billing to review the waste setting.
Setting checked (on): The wasted amount is included in the invoiced quantity, so the client is charged for what was given and what was wasted.
Example: 3 tablets dispensed, 1 wasted → invoice shows a quantity of 3.
Setting unchecked (off): The wasted amount is excluded from the invoiced quantity, so the client is only charged for what was given to the patient.
Example: 3 tablets dispensed, 1 wasted → invoice shows a quantity of 2.
Frequently asked questions
The "Add Items" button at the cabinet is grayed out. What do I do?
Confirm your Cubex user profile has the Profile Overrides permission enabled in MyCubex.
If multiple Instinct EMR products are mapped to the same cabinet item and I remove it as a profile override, which product appears on the invoice?
The product that appears first alphabetically is added to the invoice. Please contact Instinct if you’d like to discuss other options for your practice (like Department Setup).
How long does it take for line items to appear on the invoice after I dispense from the cabinet?
Line items appear within 2 minutes.
Why does the invoice show a different quantity than what was ordered in Instinct EMR?
The invoice reflects the quantity dispensed from Cubex, adjusted for any returns and subject to your waste settings in MyCubex. Update the order quantity in Instinct EMR separately if needed.
I completed an order in Instinct EMR, but it didn't go to the invoice. Why?
With Cubex Billing enabled, mapped items are only added to the invoice when dispensed from the cabinet. Completing an order in Instinct EMR no longer sends it to the invoice.
What if I already have Cubex Profile Ordering but not Billing?
Contact the Instinct team to add billing to your integration. In the meantime, see Set Up Cubex Billing to prepare for the change.
What if I have the same medication stored in Cubex and somewhere else (e.g., a crash cart)?
One option is to set up two separate versions of the product in Instinct EMR—one mapped to Cubex and one unmapped. This ensures accurate tracking and billing for both storage locations. Alternatively, you can manually add the mapped product to the invoice.
What if I need to check a client out before dispensing a prescription?
Manually add the charge to the invoice before closing it. Once an invoice is closed, further Cubex charges will not post to it.
Still need help?
Contact support via live chat or email [email protected].