Skip to content
Veona Help Centre

Billing — Charges to Claim to Remittance

import { Steps } from ‘@astrojs/starlight/components’;

Who / when: a Billing Clerk and Billing Manager turning the clinical events of a patient’s stay into an invoice, an insurance claim, and collected payment — with a Cashier taking the patient’s share.

HMO = Health Maintenance Organisation; NHIS = National Health Insurance Scheme (the payers). A Charge starts Open; an Invoice groups charges; a Claim is submitted to a payer; Remittance is the payer’s response. eSign PIN = the 6-digit code re-entered for privileged reversals.

  1. As clinical events complete, charges accrue automatically: a lab result release, an imaging report sign, a drug dispense, a theatre procedure, and each ward bed-day all raise an Open charge priced from the catalogue.
  2. On discharge, Veona assembles all Open charges into one Invoice (state Unpaid), raising the patient balance.
  3. Billing Clerk — open Bill → Overview (/bill). Open the invoice and review the line items; each carries the audit trail back to the clinical event that raised it.
  4. Billing Clerk — for a patient with HMO/NHIS cover, choose Create Claim (or open Bill → Claims, /bill/claims). Select the payer scheme and the invoice; the claim is created in Draft.
  5. Billing Clerk — review the coverage and Submit to payer. A FHIR Claim bundle is sent; the claim state becomes Approved, Rejected or Pending-Info.
  6. Billing Manager — when the payer pays, open Bill → Remittance (/bill/remittance) and post the remittance against the claims; the invoice balance decrements.
  7. Cashier — collect the patient’s remaining share (co-pay) on Bill → Payments (/bill/payments) or the Cashier desk. The invoice settles to zero.

What happens next: the settled invoice and its payments are retained for reporting in Veona Pulse (Revenue & Finance and Revenue Assurance dashboards). Refunds or credit notes, if needed, are Billing Manager actions and are eSign-PIN gated.