Veona Bill

What this is

Veona Bill is the revenue surface. It turns the clinical work that happens elsewhere in Veona into money owed and money collected. Most charges are not typed in by hand — they auto-accrue from clinical events as they complete, then get assembled into an Invoice, optionally submitted to a payer as an insurance Claim, and reconciled against Payments and Remittance.

Key terms used on this page:

• Charge — a single billable line raised by a clinical event (e.g. one lab test released, one drug dispensed). Charges start in the Open state.
• Invoice — a grouped set of charges presented to a patient or payer for settlement. Supports multiple currencies and scheme (payer) pricing.
• Claim — an invoice (or its covered lines) submitted to an HMO (Health Maintenance Organisation) or NHIS (National Health Insurance Scheme) payer for reimbursement.
• Remittance — the payer’s response to claims: what they approved, rejected, and paid.
• Credit Note — a formal reversal that reduces an issued invoice (eSign-PIN gated).

Who uses it

Roles below are the canonical billing roles:

• Cashier — collects payments, captures charges, takes deposits, builds estimates and statements, and takes installment payments. Read access to invoices. Does not create invoices or submit claims.
• Billing Clerk — everything the cashier does for assembly plus creating invoices, submitting claims, requesting pre-authorisations and refunds, and creating payment plans.
• Billing Manager — the full surface, including the privileged reversals: voiding an invoice, issuing a credit note, approving a refund, posting a claim, deciding a pre-authorisation, and managing billing config / payment gateway / settings. Privileged reversals (void, credit note) are eSign-PIN gated.

The Administrator holds every billing capability.

Editions

Veona Bill is included in the Health Centre, Hospital and Network editions. A facility whose edition does not entitle the module sees no Bill screens, and any attempt to reach them is refused.

Screens

The Veona Bill work surfaces:

Overview · Charge Capture · New Invoice · Cashier · Payments · Claims · Pre-Authorisation · Remittance · Deposits · Refunds · Receivables · Statements · Estimates · Payment Plans · Credit Notes · Service Hold · Tariffs · Payer Contracts · Time Tiers · Payers · Capitation P&L · Reconciliation · Reports · Settings.

The Invoice detail and Claim detail screens are reached by clicking a row in their parent list (Overview / Claims), not from a standalone tab.

Read the Billing Overview

Overview is the billing landing screen — the revenue-cycle dashboard you open first. Four tiles across the top read live from your books: Revenue Today, total Outstanding, Claims Pending with a payer, and your Collection Rate. Below them, Recent Invoices lists the latest bills — search by patient, payer or invoice number, click any row to open its detail, or take a payment inline without leaving the list. The Outstanding By Payer panel shows who owes you the most. Use the header buttons to jump straight to the Cashier desk or start a New Invoice. Every figure is computed from live activity, so a fresh facility shows zeros rather than sample numbers.

How charges auto-accrue

You rarely create charges by hand. As clinical events complete, Veona raises Open charges automatically through a central billable seam:

• A lab result is released → a charge per test, priced from the lab catalogue.
• An imaging report is signed → an imaging charge.
• A prescription is dispensed → a charge for the drug × quantity.
• A theatre procedure completes → surgery fee + consumables.
• A ward bed-day accrues → daily rate × length of stay.
• A patient is discharged → all Open charges are settled into one Invoice.

The Charge Capture screen is where you review these accrued charges and, when needed, add a manual charge for a billable event the system could not infer.

Assemble and issue an invoice

1. Open Charge Capture and confirm the patient’s Open charges.
2. Open New Invoice. Select the patient; their Open charges populate the invoice lines.
3. Choose the currency and the applicable scheme (payer) so each line is priced against that scheme’s tariff. Tariffs are maintained on the Tariffs screen and payers on Payers.
4. Review the line items — each carries the audit trail back to the clinical event that raised it.
5. Issue the invoice. The patient’s balance rises; the invoice appears in Overview in the Unpaid state.

Create and submit an insurance claim

For a patient with HMO/NHIS coverage, the covered portion of an invoice is submitted to the payer.

1. From the invoice (via Overview → row → detail) or the Claims screen, choose Create Claim.
2. Select the payer scheme and the source invoice. The claim is created in the Draft state.
3. Review the coverage percentage and covered lines.
4. Submit to payer — the claim moves out of Draft and a FHIR Claim bundle is sent. (Billing Clerk or Billing Manager.)
5. The payer processes and responds; the claim’s state becomes Approved, Rejected, or Pending-Info.

Record payments and remittance

1. When the payer remits, open Remittance to reconcile what was approved and paid against the submitted claims. Posting a remittance is a Billing Manager action.
2. Patient-side collections (co-pays, cash, card) are taken on Payments or the Cashier desk. Each recorded payment decrements the invoice balance.
3. Deposits hold pre-paid amounts; Statements and Receivables track outstanding balances.

Refunds and credit notes

1. A cashier or clerk requests a refund from Refunds.
2. A Billing Manager approves the refund.
3. To reverse part of an issued invoice, a Billing Manager issues a Credit Note. Both invoice void and credit-note issuance are eSign-PIN gated — you re-enter your 6-digit eSign PIN to confirm.

Payment methods, plans and pre-authorisation

• Payment Plans split a balance into installments; the cashier and clerk can take installment payments.
• Pre-Authorisation requests payer approval before a procedure; a Billing Manager decides incoming pre-auths.
• Tariffs, Payers, Capitation P&L and Settings configure how prices, schemes and the payment gateway behave.

Track Receivables and Bill a Patient

Receivables is where you see what is owed and turn a patient’s unpaid services into a bill in one step. The tiles show your total outstanding split by age — 0–30, 31–60 and 60+ days — so the oldest debt is always visible.

To bill someone, pick the patient (search by name or UHID). Veona pulls in every unpaid consumed service they have — each line showing the service, where it came from, who signed it off, the quantity, the amount and how many days old it is. Choose the payer type (self-pay, HMO, insurance or corporate) and, for a covered patient, the payer, scheme and member number. Add an optional invoice discount with a reason if you are giving one. Then:

• Bill & Collect gathers all the outstanding charges into a single invoice ready for payment.
• Bill & Submit HMO Claim does the same and submits the covered portion to the payer as a claim in one action.

The Receivables by Payer table at the foot ages the whole book by payer and patient, so you can chase the largest and oldest balances first.

Place a Service Hold

Service Hold shows whether a patient is blocked from non-emergency services because they owe money. Pick a patient and Veona reads their live outstanding balance: if they owe, the screen shows Service On Hold with the itemised services behind the balance; if they owe nothing, no hold is in effect.

When a hold is in effect you can resolve it straight from the screen — Take Payment Now at the cashier, Take a Deposit, or Bill Patient to pull the outstanding services into an invoice. Whether owing patients are actually stopped at booking, and how large a balance is allowed before the block bites, is governed by Block Owing Patients and the Balance Allowance in Billing Settings; a deposit or a payer pre-authorisation clears the block.

Reconcile Takings by Channel

Reconciliation totals what you have collected by payment channel so a till can be balanced against the payment ledger. Each channel — Cash, Mobile Money, Card and Transfer — shows its transaction count, the value already Cleared, the value still Settling, and the channel total. The tiles above sum transactions, cleared and settling takings across all channels. Everything is drawn from recorded payments, so a fresh till reads zero until money is taken.

Read Billing Reports

Reports gathers the revenue-cycle headline figures — Revenue Today, total Outstanding, Claims Pending and your Collection Rate — with the Receivables by Payer aging breakdown beneath them. Every number is aggregated live from your billing activity, so a new facility shows zeros rather than illustrative totals. Deeper statutory and ministry reporting lives in Veona Pulse.

Track Capitation Profitability

Capitation P&L tells you whether your capitation contracts make or lose money. On a capitation scheme you are paid a fixed amount per member per month (PMPM) regardless of how much care those members use — so profitability turns on whether the care you actually deliver costs more than the capitation you are paid.

For each contract the screen sets the contracted PMPM revenue (the per-member rate times enrolled members) against the actual cost of care delivered to that scheme’s members in the period, and shows the margin, the cost per member and a loss ratio. The tiles summarise total PMPM revenue, total cost of care, overall margin and how many contracts are loss-making. A red loss ratio flags a scheme that is costing you more than it pays — the ones to renegotiate.

Maintain Payers and Schemes

Payers is the register of the insurance and corporate schemes you bill against. Each scheme belongs to a payer and carries the terms Veona applies whenever a covered patient is billed: the coverage percentage, the co-pay amount, the claim window (how many days you have to submit), the billing model (fee-for-service, capitation or mixed), and whether the scheme requires pre-authorisation.

Select Add Scheme (or Edit a row) to set these. Pick the payer from the searchable directory, name the scheme — for example NHIS Formal Sector — and set its coverage, co-pay, claim window and model. Toggle Requires Pre-authorisation for schemes that must approve a procedure before it happens, and Active to control whether the scheme is offered when billing. These terms flow straight into the invoices, estimates and claims of any patient on the scheme.

Maintain Tariffs and Price Lists

Tariffs is your service price list — the catalogued services and their prices, per payer. Each row shows the service, its code, its source and the self-pay price. Overlay a scheme and the list adds that scheme’s negotiated price and coverage percentage beside each item, so you can see exactly what a covered patient and their payer each pay.

This screen is the read view; to add or change priced services, use Edit Price List, which opens Billing Settings. Tariff prices are what invoices, estimates and claims resolve against, so keeping them current keeps every bill correct.

Author a Payer Tariff Contract

Payer Contracts is where a payer’s negotiated schedule lives — the prices and coverage you actually agreed with an HMO, held against the dates they apply from. Where Tariffs shows your own price list, a contract records what one payer pays for those same services, so a covered patient is billed the agreed amount rather than your list price.

Select New Contract to start one. Choose the payer, optionally narrow it to a single plan (leave it empty and every plan on that payer falls back to this schedule), name it — for example Hygeia HMO 2026 — and set the dates it runs between. Record the source reference of the signed schedule so any price can be traced back to the document that agreed it. A new contract is always a draft: it is stored, but it does not price anything yet.

Import Schedule fills the contract from the payer’s own file. Upload or paste the rows and select Preview Changes: Veona matches every row against your service catalogue and reports what would happen — how many lines are new, which are changed (with the before and after price), which are unchanged, which are removed, and which are unmatched because no service in your catalogue carries that code. Nothing is written until you select Apply Schedule. If the file is the payer’s complete schedule rather than a partial update, tick the box to remove contract lines it does not mention; leave it clear and a partial file can only add and amend, never strip cover the payer still provides. Export CSV downloads the current lines in the same column order, which also gives you a template to send the payer.

Once the schedule reads correctly, select Activate. This is the step that puts the contract into force — only an active contract prices anything, and Veona records who approved it and when. Activating also retires any earlier contract covering the same payer and plan, closing its dates where the new one begins, so historic bills still reprice against the schedule that was in force at the time. A contract with no priced lines cannot be activated.

Two tools keep a contract current without re-keying it. Bulk Adjust moves every price on the contract by one percentage — the annual uplift — and previews each movement before applying it; enter a negative number for a discount. Clone copies the whole schedule into a fresh draft, which is how you start next year’s renewal, or a second payer whose terms are close to one you already hold. Cloning to a different payer drops the copied payer codes, since those belong to the original insurer.

Each line shows your self-pay price beside the contracted price and the variance between them, so you can see the discount the payer negotiated at a glance, along with what the payer pays, their own service code, and whether the service needs pre-authorisation.

Bill Time-Based Services in Tiers

Time Tiers handle services that are billed by how long they take — psychotherapy is the classic example, where the same session bills to a different code depending on its length. A tier maps a band of minutes to the billing code it should charge at. When a timed encounter is signed and billed, Veona reads its contact minutes and captures the charge at the tier whose band the time falls into.

Select New Tier to add one. Name the service family the bands belong to, pick the code it bills from the searchable tariff, and set the minimum and maximum minutes for the band (mark the top band open-ended for the highest tier, which has no upper limit). Build one tier per band so every length maps to exactly one code; time under the lowest band’s floor is not separately billable. Toggle Active to control whether a tier is in use, and edit or remove tiers as your billing rules change.

Configure Billing Settings

Settings is where a Billing Manager configures how billing behaves for the facility, grouped into a few areas:

• Invoicing — the default payment term (how many days after issue an invoice is due, which anchors overdue aging) and whether catalogued services are priced from the tariff.
• Patient Financials — Block Owing Patients and the Balance Allowance that together decide whether, and above what balance, a patient who owes is stopped at booking.
• Claims & Payers — whether a scheme-covered invoice auto-submits a claim on issue, and whether multi-currency invoicing is allowed.
• Payment Channels — which channels, such as mobile money, are offered at the desk.
• Access & Audit — role-based access, audit logging and offline queueing.

You can also add your own custom fields to invoices, charges, payments and claims here. The tariff price list and the payer / scheme registers keep their own screens — reach them from Tariffs and Payers.

Per-practitioner consultation fee

Most facilities have one default consultation fee on the tariff. A per-practitioner consultation fee lets you give a single clinician — a senior consultant, a visiting specialist — their own consult fee that overrides the default tariff price whenever they are the attending provider.

You set it on the clinician’s record: Admin → Staff Directory → (select a staff member) → Details tab, in the Consultation Fee Override card (reserved to the Billing Manager). Turn Override Active on, type the Consultation Fee, and select Save Fee Override.

How billing resolves the price, in order:

1. An active per-practitioner override on the attending clinician wins over the default tariff price.
2. With no active override, the consultation falls back to the standard tariff price.
3. A payer / insurance scheme contracted price still wins over both. An insurance contract is never overridden by a per-doctor fee — the scheme price always governs a covered consultation.

Caution

Only the consultation (CONSULT) fee is overridable in this screen — tests, procedures, drugs and bed-days are priced from the tariff as usual. The override is not retroactive (it applies to future charges only), an inactive override is ignored, and the screen does not display the baseline tariff for reference, so check your tariff separately if you want to compare.

For the step-by-step, see Set a Per-Practitioner Consultation Fee.