Billing module

The billing module turns recorded care into invoices without asking clinical or administrative staff to fill in anything extra: activity captured during the care process is extracted, valued against agreed rates, checked, and invoiced.

From clinical data to invoice

Billing runs as a set of independent processes so critical clinical systems stay fast. An extraction step converts registered clinical activity into pre-invoice lines; a valuation step applies invoicing rules and the rates agreed with each entity and insurance subgroup; billing staff then review, adjust, and close the pre-invoice before invoicing. Extraction and valuation can be repeated, fully or incrementally, until the pre-invoice is closed, and closed pre-invoices can be transformed into electronic invoice lines in the exchange formats accepted by insurers with online billing.

Working with pre-invoices and invoices

Dedicated screens invoice admissions, consultations, tests, and emergencies, each with filters by centre, service, dates, entity, and patient. Within a pre-invoice, staff can add, modify, move, or delete lines with a recorded reason, apply discounts and manual package prices, merge or split pre-invoices, group mother and newborn charges, allocate late consumptions, and view full movement traceability. Invoice management covers statuses from invoiced and accounted to sent, partially collected, and cleared, with credit notes, observations, and multiple print formats. Less frequent tasks live in utilities: a pre-invoice planner that schedules recurring billing runs in quiet hours, recalculation, empty and grouped pre-invoices, and outstanding charge lists.

Money in

• Collections and remittances: invoice collection management, remittance grouping per insurer, imported payment files with incident logs, and accounting exports for the finance department.
• Deposits: advance payments held against future invoices, usable in full or in part at collection time.
• Cash registers: any number of independent tills with user and service assignment, point-of-sale collection in cash, card, or cheque, cash counts, session closes, and a central cash register that imports and reconciles the others.
• Budgets: priced estimates of care acts for patients and clients, with reusable default budgets.

Authorisations and medical fees

Authorisation management defines, per insurer, whether each care act is permitted, requires authorisation, or is denied, and records or verifies authorisation codes, including online connections to the funder. A companion medical fees capability settles professional fees: fee companies and professionals are registered with settlement rules (percentages, minimums, fixed amounts, and on-call duties), settlement proposals are calculated per period, reviewed line by line, and invoiced by self-billing or received invoice, with accounting files exported for the finance system.