Billing Staff – Daily Workflows & Navigation

A Billing Staff is responsible for managing patient billing, including charge capture, invoice generation, payment processing, and insurance claim handling to ensure accurate and timely financial operations.
This page provides a structured overview of billing workflows to help users efficiently navigate financial processes.

How to Use This Page

Use this page as a quick navigation guide. Each workflow represents a common billing task and shows the exact system path to follow.

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Core Billing Workflow (Primary Loop)

This is the most common workflow followed for patient billing and payment processing.

Workflow:
Service Item Mapping → Patient Billing → Invoice Workflow → Payment Processing → Optional: Insurance Eligibility → Insurance Claim → Financial Reports

Explanation

• Service Item Mapping – Map healthcare services (consultation, lab, procedures) to billable items
• Patient Billing – Capture services using Get Items from Healthcare Services
• Invoice Workflow – Manage invoice lifecycle (Draft → Submitted → Outstanding → Paid / Partly Paid / Cancelled)
• Payment Processing – Record payments (cash, UPI, card, etc.)
• Insurance Claim (Optional) – Submit and track insurance claims
• Financial Reports – Monitor revenue, outstanding, and performance

Daily Jobs To Be Done

1. Capture Patient Services for Billing

Workflow:
Service Item Mapping → Patient Billing (Sales Invoice → Get Items from Healthcare Services)

2. Generate Patient Invoices

Workflow:
Patient Billing → Invoice Workflow

3. Process Payments

Workflow:
Invoice Workflow → Payment Processing (Payment Entry)

4. Verify Charges & Billing Accuracy

Workflow:
Patient Billing → Invoice Workflow → Review → Submit

5. Track Billing & Financial Status

Workflow:
Invoice Workflow → Payment Processing → Financial Reports

6. Handle Billing Corrections & Adjustments

Workflow:
Invoice Workflow → Patient Billing → Update Invoice

7. Process Refunds

Workflow:
Invoice Workflow → Amend Invoice / Cancel → Update → Resubmit

8. Handle Partial Payments

Workflow:
Invoice Workflow → Partly Paid → Payment Processing

9. Manage Healthcare Packages

Option 1: Billing-based Package
Workflow:
Patient Billing → Get Items from Healthcare Services → Select Package Items → Invoice Workflow → Payment Processing

Option 2: Subscription-based Package
Workflow:
Package Billing → Package Subscription → Payment Processing → Package Utilization

10. Handle Insurance Billing

Workflow:
Patient Billing → Invoice Workflow → Insurance Eligibility → Insurance Claim → Payment Processing (if partial/self-pay)

Key Navigation Insight

Most billing activities revolve around three core areas:

• Patient Billing – Entry point for capturing services and charges
• Sales Invoice (Invoice Workflow) – Central hub for billing lifecycle and status tracking
• Payment Entry – Manage payments, settlements, and adjustments

From these, billing staff can:

• capture services from appointments, encounters, and lab tests
• generate and manage invoices
• process full and partial payments
• handle refunds and credit notes
• track outstanding dues and financial status

Understanding these core modules enables efficient and accurate billing operations.