Charge ticket or encounter form

Definition

This attachment type is a scanned or other image copy of the source documents which subsequently may be used to obtain information for charging or billing purposes. For example, the paper form given by the provider to the patient during an examination, which the patient takes to the front desk of the practice so that a clerk may perform scheduling, billing, or test ordering functions. Another example is the form given to the patient by a laboratory testing facility, for tests performed in the case that the ordering physician will subsequently be billing for the tests.