You can enter unpayable encounters that do not get billed to an insurance company or a patient. To do this, your Kareo PM application administrator (or other user with permissions) must first set up a custom payer scenario - "unpayable" - within Kareo PM; see section New Payer Scenario.
Once an unpayable scenario has been configured, you can create an encounter for a patient with a case that has been defined as unpayable. When the encounter is approved, it will be under the Unpayable tab of the Find Encounter window. No claims will be created for the encounter, but you will be able to track unpayable encounters when generating certain reports.