Billing and Reporting

The service charge links service description and amount to encounter, with status Draft, Approved, Invoiced or Voided. Payments hold patient, received date, amount and reference with status Pending, Confirmed or Refunded. The billing workflow validates a charge for completed care, checks the service description and USD amount, advances it through Approved to Invoiced, and ingests a confirmed patient payment.

For a rehearsal, bill the vaccination service recorded during Milo’s Completed encounter. Select that encounter and confirm the service description and amount. Check the resulting charge alongside the payment for the corresponding patient. A draft charge or pending payment remains distinguishable from an invoiced service and confirmed money.

• Billing projection. The workflow reads only encounter identity, patient identity, visit type and status for its billing decision. Clinical notes and observations stay outside that read scope. Billing Staff can understand the service without reading the clinical narrative.
• Charge outcome. The workflow validates the submitted charge and advances it through Approved to Invoiced. Billing Staff checks the resulting service amount and patient context. Completed clinical care remains the prerequisite for submission.
• Reconciliation scope. Follow the charge’s encounter to its patient, then compare Invoiced charge amounts with Confirmed payments for the agreed reporting scope. Use the patient comparison to investigate recorded charges and receipts in the agreed scope.

Agree how service descriptions and USD amounts are entered and checked. Configure external accounting and payment processing with their responsible owners before relying on the handoff. A local invoiced state must be reconciled with any external ledger before treating the external posting as complete.

Define the date scope used for reconciliation. Each payment carries received date, while encounter dates are available through the charge’s reference. Explain the encounter-date boundary used for the charge side of the comparison. Retain Pending and Refunded payments as distinct outcomes when interpreting totals.

Configure Billing Staff access around the minimal billing projection. The role’s ability to view encounter billing context must not expose clinical notes or observations through a direct record request. Test the actual access with an ordinary Billing Staff account before wider use.

Submit Milo’s valid service charge for the Completed encounter and inspect the move through Approved to Invoiced. Confirm that its encounter resolves to the intended patient and that the workflow records the confirmed payment in that patient scope. Reconcile the recorded amounts using the agreed date interpretation.

Repeat against an encounter still awaiting review and verify that it cannot be treated as completed care for billing. Submit a charge missing service description or a valid USD amount and inspect the rejection. Then attempt to read clinical notes as Billing Staff, confirming that the workflow’s restricted read scope remains effective.

Before acting on a reconciliation difference, inspect the service charges and confirmed payment references behind it. Check that the encounter resolves to the intended patient and that both sides use the agreed reporting scope. Retain unresolved amounts for Billing Staff to investigate before claiming that the patient account agrees.

• Charges Awaiting Invoice — Identify Draft or Approved service charges awaiting their billing outcome.
• Confirmed Payments — Inspect confirmed patient payments with amount, date and reference.

Rehearse billing and reconciliation after clinical review. Agree external handoffs through integrations.