Hospital

Billing, insurance and TPA

For: Billing, accounts, TPA desk

Charges collect on the patient as care is given: consultations, bed days, medicines, tests and procedures. Billing pulls them into one invoice; for insured patients the insurer's share is split out and claimed.

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Step by step

1The Billing & TPA menu#

Invoices, payments, unbilled services, insurance policies, coverage approvals and claims.

2Collect unbilled services#

New Sales Invoice for the patient, then Get Items From › Healthcare Services lists everything not yet billed. Tick what to bill.

3The invoice#

Each line shows the service, quantity and rate from the hospital's tariff.

4Insurer's share#

For an insured patient the covered amount is shown separately: the patient pays their share and the rest is due from the insurer.

5Printed bill#

The bill prints with the patient's and insurer's shares.

6Insurance claim#

An Insurance Claim gathers the covered amounts for the insurer, tracks approval and records the settlement when it is received.

7Claim lines#

Each covered service on the claim, with the amount claimed and approved.