Billing to Debt Management (Web App)

Why Use This Function:

When a Patient is examined or treated by a Practitioner, the Practitioner will bill the Patient for services rendered. The Practitioner will use an Invoice to bill the Patient accordingly. The Invoice will be made out to the main member or the person who is responsible for the account payment, the Patient's details will also appear on the Invoice. An Invoice will be generated for each visit, detailing all consultations, procedures, medications, and consumables provided to the Patient. An Invoice will have an amount per line and a total for all the line items. An Invoice can be used for tax purposes. The Invoice can also be used to show the Patient how much they need to pay for the visit. An Invoice is also known as a Tax Invoice which will indicate the VAT rate and the VAT amount.

The Contents of This User Manual:

• Creating an Invoice from the Diary Sidebar with a Booking
• Invoice Number
• Debtor and Patient's Information
• Debtor Information
• Patient Information
• Invoice History
• Invoice Details
• Add Procedure 
• Invoice Lines
• Add Procedure
• Diagnosis Code
• Billing Code
• Prescription Line Items
• Line Options
• Easy Events
• Invoice Totals
• Invoice Actions
• Close 
• Credit Note
• Reverse 
• Redo
• Quote 
• Post & Save
• Invoice from the Debtors Screen

• This user manual will start on the Diary screen.
  

• An Invoice can be created from 2 starting points:
• Diary Sidebar with a Booking
• Debtors Segment

Creating an Invoice from the Diary Sidebar with a Booking

Allows the user to create an Invoice for the Patient on the booking which has been booked on the Diary.

• Click on the Booking of the Patient for whom the Invoice will be created.

• The Diary sidebar will open.

• For an extensive explanation of the Diary sidebar, please refer to the user manual: Diary Sidebar: Navigation and Use.

• Click on the Invoice button. 

• The Invoice Details screen will open.

• An explanation will be given for each field and option on the Invoice Details screen:

Invoice Number

The unique system-generated number which identifies the Invoice.

💡Please Note: A Temporary Invoice is created automatically when a booking is made in the Diary. This Invoice remains temporary until it is posted to the Debtor’s account.

View CCA Logs

View the Credit Control history and actions for the specific Invoice you are working on.

• Click the View CCA Logs button to view the Credit Control Assistant history for the specific invoice being created.

💡Please Note: To manage Credit Control, Practices need to set up the Credit Control Assistant first. For more information regarding setting up the Credit Control Assistant, please refer to the user manual: Credit Control Management (Automated Credit Control) Setup.

Debtor and Patient's Information

The Debtor and Patient’s Demographic details will be displayed in the top left corner of the Invoice screen.

Debtor Information

• Debtor Number (GPD211): The account number linked to the person who is responsible for the account.
• File Number (FN00000123): The Number that is associated with the account holder/Patients hard copy file. 
• Debtor Name (XANDRI AMICA RAINBOW SIEBERHAGEN): The full name of the person responsible for the payment of the account.
• Contact Information (0817650595): The telephone number of the person who is responsible for the account.
• Email Address (xars88@gmail.com): The email address of the person who is responsible for the account.
• Medical Aid (DISCOVERY): The name of the Medical Aid company with whom the account holder is insured.
• Medical Aid Number (815949471): The Medical Aid membership number.
• Medical Aid Plan (SMART PLAN CLASSIC ACUTE): The specific plan or option of the Medical Aid.
• Account Outstanding (R910,90): The total amount owed on the account by the Debtor.

💡Please Note: The information in the Debtor Information section is pulled from the Debtor’s account and file details.

Patient Information

• Dependant Number (00): For Patients who have Medical Aid, this number will correspond to the Dependant number on the Medical Aid policy. 
• Name and Surname (XANDRI AMICA RAINBOW SIEBERHAGEN): The full name and surname of the Patient.
• Gender, Date of Birth and Age (♀️1988-04-26 (37 years)): The medical gender, date (yyyy-mm-dd) when the Patient was born and the current age of the Patient.

💡Please Note: It is important to ensure that the correct Patient is selected when creating an Invoice. If the incorrect Patient is highlighted, the booking must be updated to the correct Patient. Accurate Patient information helps prevent billing errors, which could otherwise result in the need to issue a Credit Note. 

Invoice History

• Click on the Latest Invoices for this Patient panel.

• The panel will expand, showing the latest Invoices that have been posted for the Patient.
  

💡Please Note: The Invoice History will show all the previous Invoices that have been posted to the Patient's account, to prevent duplicate Invoices.

• The information within the Latest Invoices for this Patient panel is divided into columns:

• Number: The Invoice Number of the previously posted Invoice for the specific Patient. 
• Date: The Transaction Date of the previous Invoice.
• Diagnosis: The ICD-10 codes used on the previous Invoice.
• Codes: The Tariff Codes used to bill the Patient on the previously posted Invoice. 
• Total: The Total Amount billed for the previous Invoice.
• Auth Nr: The Authorisation Number used on the previous invoice, if applicable.
• Service Centre: Where the previous appointment took place.
• Treating Prac: The details of the Practitioner who treated the Patient.
• Referring Prac: The details of the Referring Practitioner.
• Repeat Invoice Lines: Allows for the repeat of items from the previous Invoice.
• All: Repeats all the lines on the previous Invoice. 
• Click on the All button to add all the lines from the previous Invoice to the current Invoice.

• Selected: Allows the user to repeat specific items from the previous Invoice.
• Click on the Selected button to add only certain lines from the previous Invoice to the current Invoice.

• The Selected Lines screen will open.

• Tick the corresponding checkboxes of the desired lines which you would like to add to the current Invoice.

• Click on the Ok button to add the selected line item to the current Invoice. The Selected Lines screen will close and the item will be added to the Invoice.

Invoice Details

Shows key information about the Invoice, like the date, Treating Practitioner, and any Referring Practitioner or Authorisation codes. These details make up the total amount billed.

• Click on the Service Centre drop-down menu to select an appropriate option.
  

💡Please Note: The options on the list will display all Service Centres which have been set up at the Practice. For more information regarding how to set up Service Centres, please refer to the user manual: Add Place of Service (New Service Centre).

• Treating Prac: The Title, Initials and Surname of the Practitioner who treated the Patient.

• Date: The year, month, and day (yyyy-mm-dd) when the booking was created, as well as the service date. If the Invoice is created directly from the Debtor’s screen (without a booking), the system will use the current date by default.

• Auth Nr.: Authorisation Number - proof of pre-approval for a specific item, procedure, or amount the Patient is covered for by the Medical Aid/Insurance.

• Click on the + button to add an Authorisation Number. 

• The Clinical Info screen will open. 
  

• For more information regarding how to set up and add Authorisation Numbers, please refer to the user manual: Authorisation Setup.

• Referring Prac: The details of the Practitioner who referred the Patient to the Practice.
• Click on the Referring Prac field and start typing the name of the desired Practitioner, who has already been set up as a Referring Practitioner at the Practice. 

• Select the desired Referring Practitioner from the drop-down menu that will become available whilst typing.

• Click on the + button to add a new Practitioner to the list. 

• For more information regarding adding a new Referring Practitioner, please refer to the user manual: Add a Referring Practitioner.

• Billing Group: The preset billing rate, as determined by the Practice. 
  
• Click on the Billing Group drop-down menu to change the Billing Group that will be used for this Invoice.

💡Please Note: The Billing Groups that appear on the list are determined by the Billing Groups that are available for the specific Medical Aid.

• Click on the Copy Billing Group to all Lines button to apply the same Billing Group to the entire Invoice.

 

• Click on the Reset Default Tariffs button to reset the Tariffs on the Invoice back to the default prices set up in the system or according to billing rules

• Tick the Private Invoice checkbox to make the Patient liable for payment of the entire Invoice. This is used when the Patient’s Medical Aid funds are depleted or when the Medical Aid does not cover certain procedures.

• Tick the Estimate Invoice checkbox to change the Invoice to a quotation. This provides the Patient with an estimate of the cost of procedures or treatments before they are performed, replacing the Temporary Invoice with an Estimate Invoice.

• For more information regarding how to create an Estimate Invoice, please refer to the user manual: Estimates/Quotes Create, View, Print and Email.

• Price List: The Price List contains the tariff codes and corresponding prices, which is used to bill Patients. The Codes and Prices have been loaded onto the system and vary depending on the Medical Aid option of the Patient.

Add Procedure 

Add Procedures to the Invoice by searching for and selecting items in the Billing Item Search screen. 

• Click on the Add Procedure button.

• The Billing Item Search screen will open.

• Click on the Search... field and enter the name of the Procedure you want to add to the Invoice. The list will filter automatically as you type.

💡Please Note: Procedures can be searched for by using the Code or Name of the Procedure. 

• Click on the desired Codes/Items which you would like to bill, to move them over to the Added Codes side. 

💡Please Note: More than one item can be selected from the list, including Medicines and Materials. 

• Click on the Delete button to remove an item.

•  Click on the Save button to add the selected items to the Invoice. 

• The selected items will be added to the Invoice.

Invoice Lines 

Invoice lines are the individual Procedures, Products, and Items listed on an Invoice. They correspond to the services provided by the Practice to the Patient. Each Invoice line usually includes a description of the item or service, the quantity, unit price, and total price. Invoice Lines provide a detailed breakdown of the charges, showing the Patient exactly what each item or procedure costs.

• The information on the Invoice Lines is divided into columns:

• An explanation will be given for each column:

• Item Number: The line number of the Procedure/Items being billed.

Diagnosis Code

A Diagnosis is the identification of a medical condition or issue by a Practitioner, determined through tests, examinations, or other procedures. 

• Click on the Diagnosis field to manually enter the Diagnosis Code, if known.

• A list of ICD-10 Codes will populate as you type.

• Click on the appropriate one on the list that becomes available as you type.

💡Please Note: It is mandatory to add a Diagnosis code to the Invoice. Without an ICD-10 code, the Patient cannot be billed.

• Alternatively, Click on the ... (ellipse) button to search for the Diagnosis code in the ICD10 Builder screen.

• The ICD10 Builder screen will open. 

• Click on the Search ICD10... field and enter the details of the diagnosis you want to add to the Invoice. The list will filter automatically as you type.

💡Please Note: ICD-10 Codes can be searched for by using the Diagnosis Code or Name of the diagnosis.

• Click on the desired ICD10 code.

• The selected ICD10 code will be added to the Added Code list section of the ICD10 Builder screen.

Please Note: More than one ICD-10 code can be added to the list.

• Click on the Remove button to remove the ICD-10 code from the list.

•  Click on the Save button to add the Diagnosis codes to the Invoice. 

• The selected Diagnosis codes will be added to the Diagnosis field.

• Click on the Clear All ICD10 Codes button to remove all the diagnoses from the Diagnosis field.

• Click on the Copy ICD10s in First Line to all Lines button to copy the ICD10 codes added in the first billing line to all the lines which the Practitioner will bill, or has already billed.

Billing Code

• Click on the Code field to enter the desired Billing Code. You can type either the code or the name to start the search.
  

• A list of Billing codes will populate as you type.

• Click on the desired code to add the Item to the Invoice.
  
  

• The Description field will be filled in automatically once the Code field has been completed.

• Click on the Qty field to enter the desired number of the specific item you would like to add to the Invoice.
  

• Click on the Repeat Items in Single Line button to repeat the Invoice line multiple times.

💡Please Note: For the Repeat Items in Single Line button to work, the quantity value should be greater than 1.

• Click on the Invoice Line Billing Group button to override the Price List associated with the line item being billed. The current Price List used by default on the specific line item, will correspond to the Price List of the entire Invoice.

• The Invoice Line Billing Group screen will open.

• Click on the Override Billing Group drop-down menu to select the desired option from the list that becomes available.

• Click on the Override Price List drop-down to select a different Price List to apply to the Invoice Line, instead of using the default one.

💡Please Note: The Lists which appear on the drop-down menus of the Invoice Line Billing Group screen will be dependent on the Price Lists loaded on the system for the Practice.

• Click on the OK button to override the default Price List with the option which has been selected.

• The Invoice Line will automatically be updated with the new price of the selected Price List.
  
  

• Amount: The Price associated with the Item/Procedure of the current line.

• MA Liable: The amount of the specific line item, for which the Medical Aid will be liable for payment when posted.
  
  

• Patient Liable: The amount for the specific Item/Procedure of the current line, for which the Debtor/Patient will be liable.
  
  

• Hover over the VAT Information icon to view the VAT Breakdown.

• Click on the Toggle the Lines Balancing field button to open the relevant fields to apply balanced billing.

💡Please Note: Balanced billing is the practice of charging a Patient the difference between the Practitioner’s fee and the amount covered by the Medical Aid. This typically occurs when a Practitioner charges more than the rate agreed upon by the Medical Aid scheme. If the Medical Aid does not fully reimburse the cost of a procedure or service, the remaining balance is billed directly to the Patient. Balanced billing is not always permitted and depends on whether the Practitioner has a contractual agreement with the Medical Aid. In cases where such an agreement exists, the Practitioner may be required to accept the Medical Aid’s rate as full payment, and balanced billing would not be allowed.

• Click on the Private checkbox to make the Patient liable for that specific Invoice line. The line will be marked as private and excluded from the Medical Aid claim. 

• Click on the Auth field to enter the Authorisation Number confirming pre-approval for the specific Item or Procedure billed on this line.

• Click on the Copy Authorisation code in the first line to all Lines button to copy the Authorisation codes added in the first billing line to all the lines.

💡Please Note: When Authorisation Numbers have already been set up for specific billing codes, the codes will be automatically added to the Invoice. 

• For more information regarding how to set up Authorisation, please refer to the user manual: Authorisation Setup.

• Tick the PMB checkbox to indicate that the line item is covered by Prescribed Minimum Benefits.

• Click on the PMB Reg No. field to enter the unique reference number issued by the Medical Aid or Insurance when a Patient is registered for a Prescribed Minimum Benefit (PMB) condition.

Prescription Line Items

Practitioners with a dispensing licence are able to add Medicine Items to the Invoice with Directions for use and the number of days the medication has been supplied etc. 

• When a Medicine Item (GMED) is billed in the Code field, additional options will be available for the specific line. 

• Click on the Generic button to search for a possible generic item.

• The Generic Medications screen will open, with generic options available for the Medicine item that was added to the Invoice.

• Click on the desired option to make a selection.

• Click on the Save button to save the changes. 

💡Please Note: The Generic Item will replace the item that was initially added.

• Click on the EMGuidance button to be redirected to the EM Guidance website. 

💡Please Note: EMGuidance is a mobile and web-based medicine and treatment platform for medical professionals. South Africa's most comprehensive, evidence-based medicines resource. An essential guideline to assist Practitioners with prescribing accurately, check contraindications and cautions, check medicine interactions, view suitable paediatric and adult dosages, adverse reactions and what the medication does.

📌Disclaimer: Practitioners will need to be signed up for an EM Guidance account to use the EM Guidance feature on the Invoice. 

• For an extensive explanation of how to use the EMGuidance feature, please refer to the user manual: Invoicing: EMGuidance.
  
  

• Click on the Days Supplied field to add the desired number of days the medication is to be supplied.

• Click on the Signata field to enter the desired directions for use.

💡Please Note: Users are able to use the default Prescription Codes set up in the Desktop App. Shortcodes allow Practitioners to create and use preset directions, most frequently used to save time while creating the prescription. For more information on how to set up Prescription Codes in the Desktop App, please refer to the user manual: Prescription Codes. 

Line Options

Additional actions available on the Invoice Line.

• Click on the Reset button to revert all lines on the Invoice to their default state, removing any custom settings or triggers that were applied.

• Click on the Delete button to remove all the lines added to the Invoice.

• An Attention! pop-up will appear to ask whether the user is sure to clear all the lines of the Invoice.

 

• Click on the OK button to clear all the lines of the Invoice. 

• Click on the Add button to add a new line to the Invoice. As many lines can be added as needed.

 

• Click on the Refresh button to update the line if any changes have been made, ensuring all information is current.

 

• Click on the Delete button to remove the desired line. 

Easy Events

Shortcut buttons to other features. Saves time and allows the user to create forms for the Patient from the Invoice Details screen.

• Click on the relevant button of the desired form to create a new form for the Patient.
  

💡Please Note: Easy Events can be set up to suit the needs of the Practice. For more information on how to set up Easy Events, please refer to the user manual: Easy Events.

Invoice Totals

Displays a summary of the financial amounts on the Invoice. It includes the total amount before VAT, the VAT amount itself, and the final total inclusive of VAT. This provides a clear overview of what is being billed and ensures transparency for both the Patient and the Medical Aid.

• Click on the Invoice Total drop-down menu to view a breakdown of the total.

Invoice Actions

More options available once the user is done capturing the Invoice.

Credit Note

• Click on the Credit Note button to create a Credit Note.

💡Please Note: The Credit Note button will be greyed out for new Invoices. Credit Notes can only be done on Invoices which have already been posted. For more information regarding how to do a Credit Note, please refer to the user manual: Invoice Corrections: Credit Notes.

💡Please Note: Before a Credit Note can be done on a transaction which was switched to the Medical Aid, the transaction will first need to be Reversed.

Reverse

• Click on the Reverse button to undo the submission to the Medical Aid after an Invoice was posted and switched.

💡Please Note: The Reverse button will be greyed out for new Invoices. Reversals can only be done on Invoices which have already been posted and switched. For more information regarding how to Reverse the transaction, please refer to the user manual: Invoice Corrections: Redo Transaction.

Redo

• Click on the Redo button to redo the transaction. 

💡Please Note: The Redo button will be greyed out for new Invoices. An Invoice can only be redone after a Credit Note or Reversal has been done. For more information regarding how to Redo the transaction, please refer to the user manual: Invoice Corrections: Redo Transaction.

• Click on the Quote button to submit a virtual claim to the Medical Aid to see if they will approve the claim or not. This helps with the authorisation process.

• The Switch Details screen will open with the response. 

• For more information regarding the Switch Response, please refer to the user manual: WA: Switch Response.

💡Please Note: The Quote feature only works on Discovery Medical Aid holders.

Post & Save

• Click on the Post Only button to save the Invoice to the system.

• Click on the drop-up menu next to the Post Only button for Switching options.

• Post and Switch: Posts the Invoice to the system and switches the claim to the Medical Aid.
• Post (Await Response): Posts the Invoice to the system and switches the claim to the Medical Aid, and waits for a response from the Medical Aid to advise if the claim has been accepted or rejected. 

• Click on the Save button to save the Invoice to the Debtor's Temporary Invoices. The Invoice will not be posted to the system.

• Click on the Save drop-up menu button for more save options.

• Save and Close: Saves the content of the Invoice and closes the Invoice Details screen to return to the main Diary screen.
• Save Lines to New Macro: Allows the user to create a New Macro with all the lines that are currently on the Invoice.
• For an extensive explanation of how to create New Macros, please refer to the user manual: Macros (Billing Combinations).