Inpatient Final Bill Generation - hmislk/hmis GitHub Wiki

Inpatient — Final Bill Generation

The final bill consolidates all charges accumulated during the admission into a single billable document. It is generated after nursing discharge is confirmed and must be settled before the admission is fully closed.

Page: Admission Profile → Billing panel → Final Bill (shown after discharge), or via menu search
XHTML: /inward/inward_bill_final.xhtml (generation), /inward/inward_bill_final_break_down.xhtml (breakdown)
Controller: BhtSummeryController / InwardBeanController
Privilege: InwardBilling

What the Final Bill Includes

Some final bill aggregates samples are given below:

Charge Category Examples
Room charges Room rent, guardian room rent
Timed services Oxygen, IV fluids, nursing procedures
Services & investigations Lab tests, radiology, physiotherapy
Outside charges External provider fees
Pharmacy issues Medicines dispensed to the BHT
Professional fees Consultant and specialist fees
Surgery fees Theatre and surgery charges
Admission items Auto-charged items configured on the admission type

Medicine that was cancelled or returned during the stay is not shown as a separate line — its value is already netted into the Medicine total, so the Medicine line reflects what was actually charged after cancellations/returns.

Bill Generation Steps

  1. Open the Final Bill page for the discharged BHT.
  2. Click Process — the system calculates all charges and updates totals.
  3. Review the line items in the bill breakdown panel.
  4. Optionally adjust line items (if permitted).
  5. Click Settle — this locks the bill and redirects to payment.

Depending on configuration, additional options appear:

  • Show an Intermediate Bill on Final Bill Edit — if enabled, Process shows a preliminary printable bill before Settle

Provisional bills are no longer saved from this page; see Provisional Bill Search to find and work with them.

Bill Breakdown

The breakdown view (inward_bill_final_break_down.xhtml) shows charges grouped by category with subtotals. This view is useful for:

  • Itemised review before settlement
  • Printing a pre-settlement itemised statement for the patient or their insurance company

Adjusting Category Totals

Each charge category row has an Adjusted Total field. By default it is editable for most categories, but locked for Room Charges, MO Charges, Maintain Charges, Nursing Charges, Linen Charges, Medical Care (ICU), Administration Charge, and Professional Charge — these are driven by other configured rules and are not meant to be hand-edited. Whether this lock applies is a per-institution setting; some institutions allow every category's Adjusted Total to be edited freely.

If the sum of the category totals doesn't match the sum of the adjusted totals, Settle can be blocked with "There is a difference between actual and adjusted values. Please Adjust category amount correctly." — also a per-institution setting; some institutions don't enforce this check.

See Application-Level Configuration for the keys that control both.

Price Matrix Value (Service Charge Margin)

If any of the admission's charge categories are covered by a configured Price Matrix, the markup the matrix applied is already folded into that category's Total — it isn't billed separately. To let billing staff see how a category's Total was arrived at, the Charges Overview panel and the Charge Types grid both show a Service Charge (Margin) figure alongside Total:

  • Charges Overview (top-right panel): Gross Total (before any matrix markup) and Service Charge (Margin) (the matrix markup), which together add up to Total Charges.
  • Charge Types grid: a Service Charge (Margin) column next to Total, per charge category — covers Room Charges, Maintain Charges, MO Charges, Nursing Charges, Linen Charges, Medical Care (ICU), Administration Charge, Professional Charge, and matrix-priced services/investigations.

Charges Overview and Charge Types showing Service Charge (Margin)

Both figures are informational only — editing Adjusted Total still works the same way described above.

Credit Company Allocation (Credit Admissions)

For an admission with Payment Method = Credit, clicking Process also splits the net due between the credit company(ies) recorded on the admission and the patient's own co-payment. See Insurance Allocation on the Final Bill for how the split is calculated and how to override it before settling.

If the credit company + patient allocation rows don't add up to the net due amount, Settle can be blocked with "Total allocation (...) must equal the net due amount (...)." — this is also a per-institution setting; see Application-Level Configuration.

Discounts

Discounts can be applied to the final bill through the Discount Matrix configuration. See Admin — Inpatient Discount Matrix.

Price Adjustments

Per-BHT price adjustments (overrides to standard fees) can be applied for services, investigations, pharmacy, and store items. See Admin — Inpatient Price Adjustments.

After Settlement

Once Settle is clicked:

  • patientEncounter.paymentFinalized = true
  • The final bill is locked — no further charges can be added
  • The Admission Profile Billing panel switches from "Interim Bill" to "Final Bill"
  • Proceed to Inpatient — Final Bill Payment

Interim Bill (During Admission)

Before discharge, an Interim Bill (running total) is available from the Admission Profile at any time. It shows the current total without finalising anything. See also the Estimated Bill which includes professional fee estimates.

Related Articles