Health Fees, Tariffs, And Pricing

Health fees are managed by combining clinical charge rules with the shared Billing, Pricing, Inventory, POS/Teller, and GL primitives.

Health explains why a patient is charged. Billing and pricing define how much is charged, who is billed, and how the money posts.

Where Each Fee Is Managed

Fee type	Where users manage it
Registration and consultation	Health visit-charge defaults, Billing items, and approved tariffs.
Lab tests	Health lab test profiles linked to Billing items and local tariffs.
Imaging	Health imaging profiles linked to Billing items, consumables, contrast, and local tariffs.
Pharmacy drugs	Medication profiles linked to operational items, stock items, Billing/POS items, and inventory price setup.
Pharmacy dispensing service	Health visit-charge defaults and Billing item tariff, where the facility charges a dispensing service fee.
Ward bed-night or hourly charges	Health inpatient charge defaults linked to ward/bed context, Billing items, and approved tariffs.
Theatre and procedures	Health procedure profiles linked to Billing items, stock consumables, implants, and procedure tariffs.
Insurance, corporate, or credit	Coverage, payer contracts, Billing invoices, claims, remittance, and payment settlement.

Where Users Open Fee Setup

User question	Workspace	What to change there
Which clinical event creates a charge?	Healthcare -> Setup -> Operating Model	Review visit-charge defaults such as consultation, lab collection, bed-night, theatre, and dispensing fees.
What appears on the patient invoice?	Billing -> Setup or the Billing item workspace used by the tenant	Maintain the Billing item, revenue category, tax behavior, and invoice-facing label.
What amount should this facility, payer, or period charge?	Administration -> Financial Setup -> Pricing	Maintain approved price books, item prices, effective dates, branch/payer rules, and tiered prices.
Which lab, imaging, procedure, or medication is billable?	Healthcare -> Setup -> Clinical Service Catalog	Bind the clinical profile to the Billing item, stock item, service profile, and pricing context.
What is the selling price of a drug or medical stock item?	Shared item prices linked to the operational item or stock item	Maintain stock identity, UOM, batch/expiry behavior, POS sale rules, Billing item linkage, and stock costing.
Which cashier receives payment?	Administration -> Financial Setup -> Tills, Payments, POS, or Teller flow	Maintain cashier tills, business days, payment channels, settlement rules, and user access.

Health defaults should not be used as the main price-maintenance screen. They tell the system that a clinical event is chargeable and which Billing/Pricing records should be used. Finance users should maintain the actual tariffs in Pricing/Billing so facility-level, payer-level, effective-date, and approval controls stay consistent with the rest of Pinkapple ERP.

Facility-Specific Prices

Different facilities can charge different amounts without duplicating clinical workflows.

Use one of these patterns:

Pattern	When to use it
Shared tariff profile	All branches use the same charge list.
Facility-specific profile	A branch or health centre has its own approved charge list.
Business-unit-type profile	Clinics, HC II, HC III, HC IV, hospitals, labs, or pharmacies need different tariffs.
Payer-specific profile	Insurance, corporate, donor, staff, or self-pay rates differ.
Effective-date price item	A charge changes from a given date while preserving old invoices and reports.
Tiered or recurring price item	The fee depends on duration, quantity, bed class, visit package, coverage limit, or service level.

For example, OPD consultation can use the same Health consultation default in every facility, while Pricing decides whether Nansana, Kampala, a donor clinic, or an insured patient gets a different approved amount.

The Charge Path

1. Health creates or proposes a visit-charge trace from a clinical event such as registration, consultation, lab, imaging, dispense, admission, bed assignment, theatre case, or discharge.
2. The trace carries the patient, encounter, facility, service line, Billing item, amount, currency, payer/coverage context, and source clinical record.
3. Billing turns READY traces into invoices and invoice lines.
4. Teller, POS, or Payments collects money and allocates the receipt.
5. Accounting posts receivables, revenue, tax, stock cost, cash, bank, write-off, refund, or remittance through GL rules owned by the relevant primitive.

Starter Amounts

The Uganda starter pack includes starter charge defaults such as OPD registration, OPD consultation, lab collection, pharmacy dispensing, inpatient bed-night, hourly bed observation, imaging, theatre/procedure, admission, and discharge administration.

These amounts are starting templates. A facility should review them before go-live and replace them with approved local tariffs. Do not treat starter amounts as national statutory prices.

Billing Items

Use Billing items to represent billable services such as:

• OPD registration
• consultation
• lab service
• imaging service
• pharmacy dispensing fee
• bed-night
• hourly observation bed
• procedure or theatre service
• admission fee
• discharge administration fee

Every billable Health profile should point to a Billing item before users start invoicing. The Billing item is what appears on invoice lines and what Accounting uses for revenue classification.

Price Books And Item Prices

Use price books and item prices where the facility needs governed tariff behavior, such as:

• fixed fees
• effective dates
• branch-specific rates
• business-unit-type-specific rates
• payer-specific rates
• scheduled or recurring fees
• rate changes that need approval
• posting or account-resolution metadata

Health service profiles and visit-charge defaults should reference approved Billing and Pricing records instead of relying on ad hoc amounts typed at the point of care.

The Uganda starter pack ships with approved tariff lines and item prices for starter visit fees, bed charges, procedure fees, and starter medication items. This lets a Billing item, operational item, or medication stock item resolve a price automatically. Finance users can still create a branch-specific or payer-specific tariff and bind it at a higher priority when a facility needs a different amount.

Drugs And Medical Items

Medication pricing should not be maintained only inside Health.

Use Health medication profiles for clinical meaning: medication, strength, dose form, route, formulary status, controlled-drug rules, and safety behavior.

Use Inventory, Product/Item, POS, and Billing setup for commercial and stock behavior: stock item, batch, expiry, unit cost, selling price, stock movement, counter sale, invoice line, and GL posting.

For sellable medication stock items, the price should resolve from the shared Pricing setup. A pricing target can be scoped by service, facility, business unit, POS profile, register, channel, effective date, and quantity tier. This allows the same medication profile to be sold at different approved prices in different facilities without duplicating the clinical medication record.

Users should treat the medication profile as the clinical catalog and the stock or operational item as the saleable item. The sale screen, Billing invoice, and Teller collection should use the approved price resolved for that item and context.

Ward And Bed Pricing

Ward and bed fees are usually recurring. Configure:

• ward, room, and bed operational locations
• bed or ward resources where used
• admission and bed-assignment workflow
• inpatient bed-night or hourly charge default
• Billing item and approved tariff
• payer or coverage rule where the stay is insured or sponsored

The scheduled inpatient billing cycle creates one charge per governed period when the patient is admitted and assigned to an eligible bed. Users should review generated charges before invoicing where the facility requires manual approval.

User Checks Before Charging

Before a service is charged, confirm:

• patient and encounter are correct
• facility business unit is correct
• service profile is linked to the correct Billing item
• approved tariff is active for the date, payer, and branch
• insurance or corporate coverage is attached where applicable
• stock item and batch are correct for drugs and consumables
• cashier point and payment channel are ready if payment is collected immediately

Related Guides

• Health Setup
• Billing, Cashier, Claims, And GL
• Uganda Starter Pack
• Orders, Diagnostics, And Pharmacy
• Inpatient, Nursing, And Theatre