Inward Admission Insurance and Credit Company Details - hmislk/hmis GitHub Wiki

Inward Admission – Insurance and Credit Company Details

Overview

When a patient is admitted under a Credit payment method, HMIS allows one or more insurance companies or corporate credit payers to be recorded against the admission. These details are stored against the inpatient encounter and are used to split the final bill between each payer and the patient.

The details entered at admission are also saved back to the patient's insurance profile so that the next time the same patient is admitted, the system can recall and pre-fill the information automatically.

Entering Insurance Details at Admission

Path: Inward > Admissions > Patient Admit

On the admission form, locate the Payment Details panel.

  1. Set Payment Method to Credit. The insurance / credit company entry form and the Payment Responsibility table appear.

  2. For each insurer or credit payer, fill in the entry form on the left:

    Field Description
    Company Name Type the insurer or credit company name and select from the dropdown
    Credit Limit The maximum amount this payer will cover for this admission
    Description Optional notes (e.g. plan type, scheme name)
    Policy Number The policy number shown on the patient's insurance card
    Reference Number Pre-authorisation or referral reference number, if obtained before admission

  3. Click Add Credit Company. The entry appears in the Payment Responsibility table on the right.

  4. Repeat for each additional insurer. A patient can have more than one credit company recorded — for example, a primary insurer and a secondary corporate credit scheme.

  5. The table shows each payer's name, credit limit, policy number, and reference number. Use the × button to remove an entry before saving.

Note: A warning is displayed at the bottom of the table reminding staff that the patient is responsible for any balance that exceeds the combined credit limits. The exact patient portion is calculated at the time of discharge billing.

Auto-Recall from Previous Admissions

If the patient has been admitted on credit before, HMIS can pre-fill the credit company details automatically when the payment method is changed to Credit.

This behaviour is controlled by the configuration option Inward Admission – Find And Fill Last Used Credit Companies of a Patient. When enabled, the system copies the credit company list from the patient's most recent credit admission into the current admission form.

Once the patient also has a Patient Insurance Profile set up, active profiles take precedence over the last-admission lookup. See Patient Insurance Profiles for details.

Saving Back to the Patient Insurance Profile

When the admission is saved, HMIS automatically updates the patient's insurance profile with the details recorded in the admission:

  • If a matching profile already exists for the patient and insurer, its policy number, reference number, and credit limit are updated to reflect the latest values.
  • If no matching profile exists, a new entry is created on the patient record.

This ensures that the patient's insurance profile is always kept current without requiring staff to update it manually after every admission.

Editing Insurance Details from the Inpatient Dashboard

Insurance and credit company details can be updated at any time while the patient is admitted, without needing to cancel and re-admit.

Path: Inward > Inpatient Dashboard > Edit Payment Details

  1. Open the patient's Inpatient Dashboard (from the admissions list or bed map).

  2. Click the Edit Payment Details button in the action panel.

  3. The Edit Admission Payment Details page opens. It shows:

    • The current payment method and discount scheme
    • The Credit Companies panel with the full editable list

  4. To add a new credit company: fill in the entry form and click Add.

  5. To edit an existing entry: update the Credit Limit, Policy Number, or Reference Number directly in the table row and click the Save (disk) icon on that row.

  6. To remove an entry: click the Remove (trash) icon on that row.

  7. Click Save at the top to confirm all changes. Click Inpatient Dashboard to return without saving.

Changes made here are persisted immediately and will be reflected in the final bill calculation.

Insurance Allocation on the Final Bill

Path: Inward > Billing > Inward Final Bill

When the final bill is processed, HMIS automatically calculates how much of the total charges should be allocated to each credit company based on the credit limits recorded at admission.

How the Allocation Works

  1. On the final bill page, click Process (or Process Bill) to calculate the charge totals.
  2. A Credit Company Allocation panel appears below the charges table (visible only for Credit admissions).
  3. Each credit company is listed with a system-calculated Allocated Amount based on its credit limit.
  4. The final row shows the Patient Co-payment — the portion remaining after all credit company allocations, highlighted in blue.

Overriding the Allocation

The system-calculated allocation is a starting point. Staff can override each company's allocated amount before settling:

  • Click into the Allocated Amount field for any credit company row and type the correct amount.
  • The Patient Co-payment row recalculates automatically to reflect the updated split.
  • The patient co-payment row can also be edited directly if an agreed amount has been negotiated.

Once the amounts are correct, click Settle to finalise the bill and record the payment split.

Tip: If the amounts need reviewing before settlement, use Save Provisional Bill (if enabled) to save the current state and return to it later without losing the entered figures.

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