Health Billing, Cashier, Claims, And GL

Health does not own a separate ledger. It creates clinical and visit-charge provenance, then hands financial work to Billing, Payments, POS/Teller, Stock, and Accounting.

Ownership Boundary

Area	Owner
Clinical charge reason and source	Health visit-charge trace
Invoice, invoice line, credit note, receivable	Billing
Cashier collection, teller drawer, till session	Payments, POS, or Teller primitives
Drug, consumable, implant, contrast stock	Inventory
GL batch, debit/credit lines, posting controls	Accounting GL posting engine
Insurance coverage, pre-auth, claim, remittance	Health Claims with Billing/Payments handoff

Visit-Charge Trace

The visit-charge trace links clinical work to billing.

Typical sources:

• registration
• consultation
• lab order/result
• imaging study/report
• medication dispense
• medication return
• procedure/theatre case
• bed-day or hourly inpatient cycle
• consumable or implant use
• discharge package

Trace statuses should move from READY to POSTED only after Billing has created or issued the authoritative invoice/line.

The transaction boundary is strict: a Health trace must not become POSTED while its Billing invoice is still DRAFT, unissued, or not GL-posted. If invoice issue or GL posting fails, the trace remains READY so the charge can be corrected and retried without losing billing integrity.

Cashier And Teller Flow

Hospital cashiers should operate from the existing teller, POS, Billing, and Payments surfaces.

1. Health creates READY charge traces.
2. Billing creates invoice and invoice lines.
3. Teller or POS collects cash, mobile money, card, or bank transfer.
4. Payment allocation updates invoice balance.
5. Settlement and GL posting run through Payment and Accounting rules.
6. Health chart shows the invoice/payment outcome as clinical context.

Cashiers should not need clinical permissions except where they review visit charges. Clinical staff should not need teller drawer permissions unless they also collect money.

Patient Payments And Accruals

Patient payment flows can be immediate, deferred, insurance-backed, credit-backed, or scheduled.

Scenario	Operational model
Walk-in cash visit	Health READY charge trace -> Billing invoice -> Teller/POS receipt -> Payment allocation -> GL posting.
Lab or imaging prepayment	Billing invoice can be created before fulfilment; diagnostic work references the paid or outstanding charge.
Pharmacy dispense	Health dispense enforces medication safety; Inventory owns stock issue; Billing/POS owns sale and collection.
Insurance-covered service	Billing invoice line becomes claim source; Health Claims handles submission/remittance; Payments settles.
Corporate or employer credit	Coverage/payer context is recorded in Health; Billing owns receivable, statements, and ageing.
Inpatient bed-night or hourly	The Health billing cycle creates idempotent charge traces per billing period; Billing invoices the READY traces.
Refund or medication return	Health records return context; Inventory handles stock return; Billing creates credit note or reversal.

Hourly and bed-night charges should be generated by a scheduled Health billing cycle using admission, bed assignment, service profile, tariff, payer, and previous billing-period metadata. The runner must be idempotent so reruns do not duplicate charges for the same patient, admission, charge source, and period.

Rule Headers And Resolvers

GL integration should reuse the existing posting-rule model used by deposits, shares, loans, POS, stock, and billing.

Health scenario	Posting rule owner
Visit fee invoice	Billing rule header and resolver tags.
Lab invoice line	Billing service-line revenue rule.
Imaging invoice line	Billing service-line revenue rule.
Pharmacy drug sale	POS or Billing revenue rule, plus Stock cost/issue rule.
Bed-night charge	Billing inpatient service revenue rule.
Theatre/procedure charge	Billing procedure revenue rule.
Claim remittance	Payments/Billing settlement and allocation rules.
Refund or credit note	Billing credit-note and Payment refund rules.
Stock issue/return	Inventory movement posting rules.

Recommended Health resolver tags include service line, charge source, payer class, payment channel, facility business unit, department business unit, stock movement type, and claim/remittance source.

Insurance And Credit

Health Claims handles eligibility, coverage, pre-authorization, claim creation, payer submission, remittance, denials, appeals, and balance handoff.

Billing still owns invoices and receivables. Payments still owns collected receipts. Claims should reference posted invoice lines rather than duplicating charge totals.

Inpatient Accruals

For inpatient and long-running care, Health can generate scheduled charge traces from:

• admission status
• bed assignment duration
• operational location or ward tariff
• payer/coverage terms
• bed-night, hourly, or package rules
• service profile defaults

The billing-cycle runner should be idempotent: the same patient, admission, charge type, billing period, and service profile should not create duplicate traces.

The billing cycle should only run for branches with fiscal period, business day, currency, tariff, cashier, and payment readiness. It should also use a clear cadence, usually daily for bed-night billing or hourly for observation beds, so users do not accidentally bill both daily and hourly defaults for the same stay.

Users should review generated recurring charges from the patient chart, Visit Charges workspace, or Billing before collection where the facility requires manual billing approval.

Fiscal And Business-Day Readiness

Every Health branch that posts invoices or collections needs:

• active fiscal calendar policy
• fiscal year and monthly periods
• BU period state for the branch
• current period opened
• business day opened where teller/day control is active
• approved currency usage for the branch
• cashier/till/payment-channel setup
• user role assignment for cashier or administrator

Related Guides

• Health Operations
• Fees, Tariffs, And Pricing
• Billing Overview
• Payments & Settlement
• Point Of Sale