Admin Inpatient Automatic Admission Charges - hmislk/hmis GitHub Wiki

Admin — Inpatient Automatic Admission Charges

Automatic admission charges are a fixed set of routine charges that the system bills on every admission, without anyone having to add them by hand. The amount can differ by the admission type (BHT, OPD Card, ETU, Day Case …) and by whether the admission is Credit or Cash.

Typical examples are an admission charge, a resident M.O. charge, a nursing care charge and an ETU charge.

Page: Admin → Manage Inpatient Services → Admission Types → Automatic Admission Charges XHTML: /inward/inward_admission_charge_item.xhtml Controller: AdmissionChargeItemController Privilege: InwardAdministration

What these charges are, and are not

These are additive charges. They sit alongside the normal room, nursing, M.O., maintenance, linen and administration charges — nothing is replaced or zeroed.

That makes them different from Inpatient Packages, which are fixed-price bundles that replace itemised billing for the whole stay.

Admitting a patient now produces exactly what a user would have produced by hand on Add Services / Investigations to BHT — the same bill structure, the same per-department bundling, the same batch bill, the same bill items and bill fees. Every other screen therefore treats these charges as ordinary inward service charges: they appear on the interim bill and the final bill under their own charge types, they can be cancelled or returned from the usual screens, and they flow into credit company debtor reporting like any other inward service charge.

The feature is inert until it is configured. With no rows on this page, nothing is charged and nothing changes.

Configuring a charge

Field Notes
Item The service to bill. Must be an item that has a department, an institution, an inward charge type and at least one fee configured
Admission Type The admission type this row applies to. Leave blank for "any admission type"
Payment Method Cash or Credit. Leave blank for "both". These are the only two values an admission can hold
Price The amount charged. This exact amount is billed — no price matrix margin and no inward discount is applied on top
Qty Defaults to 1
Order No Display order on this page

The list shows each row's inward charge type and department next to the item, because those two decide where the charge appears on the interim bill and how the generated bills are grouped. A misconfigured item is visible here before it ever reaches a bill.

Automatic Admission Charges page listing five configured charges with their inward charge type and department

The configured charges. Admission Charge is priced differently for Cash and Credit; Nursing Care applies to both; the ETU and theatre charges belong to other departments.

Why the item needs a fee and a charge type

  • No fee configured → the generated charge would cancel and return as zero, because cancellation and refund both read bill fees, not bill items. The page refuses to save such a row.
  • No inward charge type → the charge would have no heading to sit under on the interim and final bill. The page refuses to save such a row.
  • No department → the system could not decide which bill the charge belongs on. The page refuses to save such a row.

How a charge is resolved

Each configured item is resolved independently, in two steps. Admission type is checked first, then payment method.

  1. Admission type — rows matching the admission's type. If there are none, rows with a blank admission type. If there are still none, the item is not charged.
  2. Payment method, among the rows step 1 selected — rows matching the admission's payment method. If there are none, rows with a blank payment method. If there are still none, the item is not charged.

A blank in either column means "applies to all", which is how a charge that costs the same either way is configured with a single row.

Worked example

Item Admission Type Payment Method Price
Admission Charge (blank) Cash 1000
Admission Charge (blank) Credit 1200
Nursing Care Charge (blank) (blank) 2000
ETU Charge ETU (blank) 500
  • BHT admission, cash → Admission Charge 1000 + Nursing Care 2000. ETU Charge has no BHT row and no blank-type row, so it is skipped.
  • BHT admission, credit → Admission Charge 1200 + Nursing Care 2000.
  • ETU admission, credit → Admission Charge 1200 + Nursing Care 2000 + ETU Charge 500.

Nursing Care is billed at 2000 in every case, because its single row leaves the payment method blank.

⚠️ The trap to watch for

Because step 1 is a filter, adding an admission-type-specific row makes the blank-type rows stop applying for that admission type entirely.

If someone adds Admission Charge — Day Case — Cash — 800 and forgets the Day Case Credit row, then a credit Day Case admission gets no admission charge at all. Step 1 locks onto the Day Case rows, and step 2 finds neither a Credit row nor a blank row among them.

The page warns when an item has admission-type-specific rows covering only one of Cash and Credit. Take that warning seriously — the symptom is a silently missing charge, not an error.

Two warnings shown after saving: one-sided Cash-only coverage for an admission type, and a duplicate admission fee already configured on that admission type

Saving a Cash-only row for an admission type raises both warnings at once: the missing Credit row, and the admission type's own built-in admission fee.

⚠️ Do not double up with the admission type's own admission fee

Each admission type has its own Admission Fee field on Admin — Inpatient Admission Types. That value is added to the bill separately, under the Admission Fee charge type.

If an admission type carries a non-zero Admission Fee and an admission charge is configured here for the same thing, the patient is charged twice. The page warns when you configure a charge against an admission type that already has an admission fee. Pick one mechanism per hospital.

Pricing is captured at admission

The charge is resolved and billed once, from the admission type and payment method as they stand at the moment of admission.

If an admission is later converted between cash and credit, the charge that was already billed is not re-priced. Correcting it is a cancellation or a refund plus a re-bill, using the existing inward service bill screens. This matches how the rest of inward billing captures values at admission.

Which bills are produced

The charges are grouped by the department of each item:

  • Charges whose items all belong to one department → one bill, under one batch bill.
  • Charges spanning three departments → three bills, all under one batch bill.

That is exactly what adding the same services by hand produces.

Room-less admissions — Rapid and Temp A&E, where no room is assigned — are charged too. Their charges are priced against the admission's own department instead of the room's.

On the bill

The charges appear on the interim and final bill under their own charge types, alongside anything staff add by hand, and the room charge continues to accrue separately.

Interim bill showing Admission Fee 1,000, ETU Charges 500, Nursing Care 2,000 and Theater Consumables 750, totalling 4,250, with the room charge listed separately

A cash BHT admission's interim bill. The four automatic charges total 4,250 and sit under their own charge types; the 2,100 room charge is separate and unaffected.

Cancelling and returning

  • One charge bill — cancel it from Inpatient — Cancel Service Bill, or return part of it from Inpatient — Bill Refunds. These behave exactly as they do for a hand-added service.

  • The whole admission — cancelling an admission automatically reverses its admission charges first, then cancels the admission. Staff do not have to clear them by hand.

    A charge bill that genuinely may not be reversed — it has been checked, it has already been returned, or a doctor payment has been made against it — still blocks the cancellation, and the message says which bill and why. Resolve that first, then cancel the admission.

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