Bill completed care and reconcile payments

Step by step

1. Resolve completed care Billing Staff

   Billing Staff selects the charge's encounter and checks that the encounter is Completed. The workflow reads encounter identity, patient identity, visit type and status. Clinical notes and observations are excluded from the billing read scope, so clinical details should not be copied into billing simply to make the service recognizable.

   • Confirm eligibility using minimal billing context
   • Updates Charges, Encounters, Patients

2. Validate and invoice the service Billing Staff

   Submit service description and the USD amount against the intended encounter. The workflow validates those values and moves charges from Draft through Approved to Invoiced. The workflow records Approved after validating the service input. A missing description or invalid amount must not produce an invoiced service.

   • Move Draft through Approved to Invoiced after validation
   • Updates Charges

3. Record the confirmed patient payment Billing Staff

   The workflow ingests a Confirmed payment for the patient. Inspect the payment amount, received date and reference in that context. Pending and Refunded remain separate states. Configure any external payment handoff separately and reconcile its confirmed result.

   • Retain confirmed money with its patient reference
   • Updates Payments, Patients

4. Compare the billing scope Billing Staff

   Billing Staff groups Invoiced charges through the encounter's patient and compares them with Confirmed payments for the agreed date scope. Explain the chosen encounter-date boundary and retain any difference for investigation with the responsible billing owner.

   • Compare billed and paid patient totals
   • Updates Charges, Encounters, Payments

Billing Staff

, Admin.