In Instinct EMR, practices can pay provider commissions using one of two reporting methods: Gross Invoicing or Collected Invoicing. This article explains how each method works, how to handle unpaid invoices under each approach, and which method Instinct recommends for most practices.
Warning: Your practice must use ONE of these two methods—not both. Mixing methods will result in inaccurate provider commission reporting.
Option 1: Gross Invoicing (recommended for most practices)
With Gross Invoicing, providers are paid commission based on the revenue from invoices closed during the reporting period. Once an invoice is closed, its close date determines the production month for that invoice and all associated providers.
This method is straightforward: each reporting period, you pay providers a percentage of the sales they generated. Because invoices cannot be reopened in Instinct, the reporting period closes automatically and past reports are never affected by future changes.
Note: What Instinct calls "gross" invoicing is technically "net" production reporting—amounts are calculated post-discount. Because commissions are rarely paid on pre-discount amounts, Instinct uses the term "gross" to reflect this standard practice.
How to manage unpaid invoices with Gross Invoicing
If a client does not pay and the invoice is sent to collections or written off, create an adjustment invoice at that time, using negative-quantity line items for the amounts that were never collected.
If you want to deduct the write-off from the provider's commissions, place the negative line items under that provider on the adjustment invoice.
If you do not want to deduct from the provider's commissions, place the negative line items under a generic practice provider instead.
Once the adjustment invoice is closed, it will appear in the collections report for the following period, creating a true-up so totals align over time.
Tip: To protect practice cash flow during periods of high accounts receivable, consider holding a portion of commission payouts—for example, paying out 75% each quarter and holding 25% for a Q4 true-up. This gives your practice time to write off unpaid invoices before finalizing annual commission totals.
Instinct strongly recommends this method for most practices. It is clean, predictable, and requires minimal reconciliation over time.
Option 2: Collected Invoicing
With Collected Invoicing, providers are paid commission based on revenue actually collected during the reporting period—excluding payments and refunds applied to closed invoices. This method is available for practices with advanced accounting systems that require real-time collections reporting.
This report shows sales by provider on closed invoices, but only for line items that have payments applied to them. It works well when invoices are fully paid, but it introduces complexity when invoices are partially paid or paid across multiple periods.
Complexities to be aware of with this method:
Invoices can have multiple providers.
Invoices are often partially paid over time.
Tracking payments and refunds on individual line items over time is required.
Payments and refunds can be applied before or after an invoice is closed.
Payments and refunds can be moved if applied in error.
Invoice status can change from open to closed across reporting periods.
Reports involve multiple dates to reconcile (invoice close date, line item date, payment/refund date) that can conflict and span multiple reporting periods.
Warning: Do not use the Collected Invoicing report to compare totals against other reports in Instinct. Because of the multiple date ranges involved in this report, cross-report comparisons are not reliable.
How to manage unpaid invoices with Collected Invoicing
If using Collected Invoicing and an invoice is not paid, deduct the unpaid amount using a method that places negative line items under the generic practice provider—not under the actual provider. Placing negative items under the actual provider will effectively reduce their revenue commission they were never paid out on in the first place, since Collected Invoicing only pays commission on items that have received payment.
Instinct recommends this method only for practices with an advanced accounting team that fully understands the nuances of collected invoicing and has the time to manage the additional complexity.
Frequently asked questions
Which method does Instinct recommend?
Gross Invoicing is strongly recommended for most practices. It is simpler to manage, produces predictable reporting, and handles write-offs cleanly through adjustment invoices.
Can I switch from one method to the other?
Yes. Contact Instinct support for guidance on switching methods and ensuring your historical reporting is handled correctly during the transition.
Where can I learn more about the specific reports for each method?
See the Provider Summary and Details Report: Gross Invoicing and Provider Summary and Details Report: Collected Invoicing articles for full report documentation.
Still need help?
Contact the Instinct support team via live chat or email [email protected].