Our Healthcare service client use hospital software to manage their daily medical transactions, while the hospital’s accounts department uses a separate ERP system to maintain financial records. Therefore, it is essential to establish integration between the healthcare service departments and the accounts department to ensure that daily billing transactions are recorded accurately in the ERP system without any discrepancies.
What is an Encounter Number?
An Encounter Number is a unique reference assigned to every patient interaction with a healthcare facility, whether it is:
- Outpatient (OPD)
- Inpatient (IPD)
- Emergency visit
What is an UHID Number?
A UHID number (Unique Health Identification Number) is a unique ID assigned to every patient in a healthcare system or hospital. It is used to identify and track a patient across all visits, treatments, and medical records.
How Multiple Medical Billing Transactions Are Integrated
During a patient’s journey, multiple transactions are generated. These are captured in the hospital system and then integrated into the ERP using the UHID and Encounter Number.
- UHID Registrations:
- Basically, UHID number is mapped with customer number in the ERP system.
- There is no financial impact initially, but acts as the foundation for all future transactions
- Payment of Billing transactions
- Basically, payment transactions in healthcare are divided into two main categories: self-pay and payments made by third party. However, there are multiple real-life scenarios in which patients settle their medical bills.
- Some common scenarios include:
- The patient pays 50% of the bill as self-pay, while the remaining 50% is covered by the insurance company.
- The entire medical bill (100%) is paid by the self-pay.
- The bill is split among multiple sources, such as 30% self-pay by the patient, 30% covered by government subsidy, and 40% paid by the insurance company.
- In some cases, patients deposit a fixed amount in advance monthly, which is later adjusted against future medical bills.
- Initial Prepayments
- At the time of patient registration, the hospital collects an advance amount to secure the treatment and cover initial expenses.
- This advance is recorded against the patient’s encounter number with UHID number.
- Our integration maintains the encounter number an UHID number wise all the initial payment in ERP system, so the prepayment is later adjusted against the final bill generated for the encounter.
- Government Subsidies
- Certain patients are eligible for government healthcare schemes that cover part or full treatment costs.
- The subsidy amount is linked to the encounter number with UHID number.
- The ERP system records this amount as a receivable from the government authority.
- Maintain Discount Entries
- The ERP system maintains a proper audit trail for all discounts applied.
- These discounts are recorded at the encounter number level and reduce the overall billing amount.
- Outpatient and Inpatient Maintenance
- The system differentiates between outpatient (OPD) and inpatient (IPD) encounters.
- All services are recorded under the same encounter to ensure complete and consolidated billing.
- Accounts Payable – Doctor Pay
- Hospital some time appoint the doctors from outside clinic to provide the service in hospital.
- The hospital calculates the doctor’s share (fixed or percentage-based) from the billed services.
- All the payment transactions have been recorded based on the encounter number with UHID.
- Invoice Entries
- Once all services are completed, the hospital generates a final invoice for the encounter.
- The invoice includes all charges such as consultation, procedures, room rent, medicines, and services which is maintained by patient’s encounter number with UHID wise.
- Our ERP system fetch all the information from Hospital software and generate a invoice with maintain the encounter number with UHID.
- Refund on Credit Notes
- If the patient has already paid and a credit balance arises, the hospital processes a refund.
- Based on the encounter numbers, all the payment entries have been recorded so when customer demand for refund then the ERP system calculate their total payment entries and deduct their invoice amount and pay the balance amount as a refund entry.
- Consumption GL (General Ledger)
- Medicines, surgical items, and consumables used during treatment are recorded as consumption.
- Our integration system generates the GL entries to show this entries into the proper GL accounts based on the selected the consumption type like Medical consumption show in medical GL accounts and other item consumption entries show in other GL accounts.
Our Integration screen will look like as below.
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