Service billing

A service charge belongs to an encounter and carries its description, amount and status. Clinical Coordinator prepares permitted charge drafts and follows approved service charges through the billing action. That action validates the encounter and patient context before an Approved charge becomes Invoiced.

Payments belong to the patient and retain their amount, received date and reference. The authorized billing command ingests a genuinely confirmed payment and reconciles billed and paid scope for the patient. An encounter reference or familiar patient name is not enough on its own: the command must resolve the actual linked records before accepting the effect.

• Approved charge input. Billing starts from an already Approved service charge. Clinical Coordinator can prepare the permitted draft and inspect the approved source. The clinic agrees who establishes that approval and what evidence supports it before enabling the billing action.
• Payment confirmation. Pending, Confirmed and Refunded remain distinct payment states. The confirmed result must come from the authorized source process, with its reference retained so the team can inspect what the receipt represents.
• Patient-level reconciliation. Charges reach the patient through the encounter, while payments reference the patient directly. Compare the agreed billed and paid scope at that level and investigate discrepancies before making claims about a particular charge’s settlement.

Agree the service-description vocabulary, amount precision and currency interpretation used by the clinic. Identify the source of approved charge authority and the actual confirmation evidence needed for a patient payment. Keep clinical review authority separate from billing permission; a clinical decision does not automatically approve a service charge.

Choose the scope used when comparing billed and paid amounts. Confirm how refunded or voided records appear in that review and how the clinic handles corrections through the responsible system. If an accounting or payment provider is connected, agree its record mapping and authoritative response. Clinical Governance Administrator and clinical evidence reviewers should retain their defined boundaries rather than gaining billing access through a shared screen.

Rehearse an Approved charge for an identified patient’s completed encounter. Clinical Coordinator requests the billing action and confirms the charge becomes Invoiced only for the intended encounter. Supply a genuine confirmed payment for the same patient and inspect its reference alongside the patient’s billed scope.

Repeat with a payment belonging to a different patient, a Voided charge and an absent or negative amount. The invalid command must be rejected without partial writes. Repeat the original valid operation and verify that the same request does not duplicate the billing effect. Finally, compare the patient totals and inspect any discrepancy without assuming that a patient payment has been allocated to a particular charge unless the connected process establishes that allocation.

• Charge register — Service charges with their encounter, amount and billing state.
• Payment register — Patient payments with confirmation state, reference and received date.
• Patient register — Identity context for checking the correct patient’s billing scope.

Use approved service billing after patient readiness and admission establishes the encounter context.