Printable hospital template
Patient balance ledger for charges and part payments
Carry patient charges and confirmed payments across dates with invoice references, a running balance and a clear opening position for each ledger period.
- Written by
- RizCare
- Published
- Last reviewed
RizCare's suggested worksheet. Adapt to your hospital. https://riz.care/library/templates/patient-balance-ledger
For billing staff following a patient account across more than one visit.
A patient pays against an older bill and receives a new charge on the same day. Keep both references beside the running balance so the next receptionist can explain what remains due. Use one ledger per patient account and retain the invoices behind it.
A ledger is a summary, not a replacement receipt. Check the patient and folder reference before posting anything. A relative paying on someone's behalf does not become the patient named on the account.
Print this page or save it as a PDF from your browser. The print layout contains only the blank worksheet and its completion note. Fill it in within your hospital.
Practice: ____________________ Prepared by: ____________________ Date: ______________
| Field | Entry |
|---|---|
| Patient / folder reference | |
| Period | |
| Opening balance evidence |
| Date | Reference | New charge | Received | Balance | Allocation / explanation |
|---|---|---|---|---|---|
| Blank entry | |||||
| Blank entry | |||||
| Blank entry | |||||
| Blank entry | |||||
| Blank entry | |||||
| Blank entry |
Keep completed copies with the staff authorised to use them.
How to use it
Agree the opening position
Write the ledger start date, patient reference and the invoices making up the opening balance. Carry a checked balance from the previous period once. Do not copy the same old invoices into the new-charge column as well. If the starting figure is disputed, record that dispute and its owner before presenting it as settled.
Post charges and receipts as different entries
Add each new invoice in the charge column, using the service record and approved bill as evidence. Enter each confirmed payment in the received column with the receipt reference, method and invoice allocation. A payment received today can settle yesterday's invoice without creating a new charge.
The bookkeeping manual hosted by FAO distinguishes money received from credit sales and customer balances. Its setting is general business training in Liberia. The patient-account layout here is our suggested adaptation.
Source: Bookkeeping and Financial Management Training Manual, April 2013.
Calculate and explain the running balance
For each row, take the previous balance, add the new charge and subtract the confirmed amount received. If one payment covers several invoices, document how it is allocated in the source record. Do not post the full payment separately against each invoice. A reported transfer remains a follow-up item until the hospital confirms receipt.
Review corrections without losing the trail
An authorised adjustment needs its own explanation and reference to the original record. Do not erase a charge or receipt because a patient asks about it. A refund involves money being returned; correcting a payment entry is a different action. Investigate an unexpected credit balance rather than treating it as permission to pay money out.
What each field means
- Patient and period
- Use the hospital's established folder reference and period dates. Keep identifying information in the controlled hospital copy, with access limited to staff handling the account.
- Date and reference
- Record the date of the relevant charge or receipt and a reference that reaches the original evidence. A date alone cannot distinguish two payments made on the same day.
- Charge / received
- Use one column for new billed amounts and the other for confirmed money received. The worked example contains no discounts, refunds or credit notes.
- Balance
- This is an amount remaining on the account, not profit and not the cash in the drawer. Reconcile the closing amount to the invoices before starting another period.
- Allocation or explanation
- Name the invoice a receipt settles. Keep an unresolved allocation visible and refer it to the authorised billing person instead of guessing from an amount that happens to match.
Completed fictional example
Fictional amounts only. The closing 9,000 naira consists of 6,000 still due on I-090 and 3,000 due on I-101. Collections in the period are 9,000 naira; new charges are 12,000 naira.
| Field | Entry |
|---|---|
| Patient / folder reference | Fictional folder F-0042 |
| Period | 1-9 September 2026 |
| Opening balance evidence | 6,000 naira outstanding on invoice I-090 |
| Date | Reference | New charge | Received | Balance | Allocation / explanation |
|---|---|---|---|---|---|
| 1 Sep | Opening | 0 | 0 | 6,000 | I-090 carried once |
| 8 Sep | I-101 | 12,000 | 0 | 18,000 | New invoice |
| 8 Sep | R-201 | 0 | 4,000 | 14,000 | Cash against I-101 |
| 9 Sep | R-202 | 0 | 5,000 | 9,000 | Confirmed transfer against I-101 |
Related resources
Sources and review
The worksheet design and examples are RizCare's recommendations. The sources below support the background discussion; they do not endorse this form.
- Bookkeeping and Financial Management Training Manual, April 2013 (Forest Instrument Liberia project, hosted by FAO). Read 9 September 2026.