Revenue cycle

A charge holds a service description, amount, encounter and status. Billing Specialist prepares the charge in Draft against the visit where the service occurred. Finance Manager reviews the described service and amount, then decides whether the charge should move to Approved. That is the approval point in this operating cycle. Once invoiced, the charge can be distinguished from a merely approved one; a Voided charge remains visible as a different outcome.

Payment records hold the patient, amount, received time, reference and status. They are patient-level records. Billing staff should use the reference and the surrounding encounter context to reconcile received money with approved or invoiced services. Use the payment reference and encounter charge details in the finance team’s reconciliation, especially when a patient has more than one open visit.

• Charge preparation. Billing Specialist enters the service and amount against the encounter.
• Approval. Finance Manager checks the charge before its status becomes Approved.
• Collection. Billing Specialist records the patient payment and Finance Manager confirms the receipt.

Agree service descriptions, who can prepare charges, and who has authority to approve them. Set a review rule for an unusually high amount or a charge entered against a closed encounter. Decide how the team records a void and who explains it in the financial handoff. Establish how finance matches patient-level payments to encounter charges during reconciliation. If an accounting or invoicing platform is used, define the connection, timing and reconciliation owner before it is treated as a source of posted revenue.

A clinician completes a visit and Billing Specialist reviews the encounter’s service. They enter a charge in Draft with the description and amount. Finance Manager opens Charges awaiting approval, checks the service against the care record and approves it. Billing Specialist can then follow the charge into the invoiced state. When the patient pays, staff record the amount, receipt time and reference against the patient. Finance Manager checks the receipt and confirms it.

If a charge is wrong, resolve it before approval or use the Voided state under the hospital’s correction procedure. If a payment is refunded, its Refunded status should remain distinct from Confirmed. During reconciliation, review the encounter charges alongside the patient’s payment references. Check the payment reference and service context together when explaining which visit a receipt settles.

• Charges awaiting approval — Present draft services and amounts for the finance decision.
• Approved charges — Follow approved and invoiced encounter charges.
• Payment confirmation queue — Review pending receipts before confirmation.

See charge and payment and care delivery.