---
title: "Bill Transaction"
description: "How to create and manage patient bills in NICE HMS — OPD billing, IPD billing, pharmacy billing, lab billing, and GST-compliant invoice generation."
date: 2026-07-19
lastModified: 2026-07-19
category: "billing"
author: "Dr. Umesh Bilagi"
beta: true
---

## Overview

Bill Transactions are the primary billing mechanism in NICE HMS. Every service — consultation, lab test, medicine, procedure, room charge — flows through a bill transaction linked to a patient.

## Creating a Bill

### OPD Bill

1. After an OPD consultation, go to **Billing > New Bill**.
2. Select the patient and encounter.
3. The system auto-loads billable items:
   - Consultation fee (based on doctor's rate)
   - Lab tests ordered (if any)
   - Pharmacy items dispensed (if any)
4. Review and adjust quantities/prices if needed.
5. Apply any applicable discounts.
6. Click **Generate Bill**.

### IPD Bill

IPD bills aggregate all charges during the admission:
1. At discharge, go to **Billing > IPD Bill**.
2. The system compiles:
   - Room charges (daily rate x number of days)
   - Doctor visit charges
   - Procedures/surgeries
   - Lab and radiology charges
   - Pharmacy/consumables
   - Miscellaneous charges
3. Review the consolidated bill.
4. Apply advance payments (see [Advance Transaction](/docs/advance-transaction)).
5. Generate the final invoice.

### Pharmacy/Lab Bill

Typically created automatically when items are dispensed or results are finalized. Can also be created manually from the respective module.

## Bill Components

| Component | Source |
|-----------|--------|
| **Items** | From Accounts Master / Item Management |
| **Quantity** | E.g., number of tablets, number of days, number of tests |
| **Rate** | Configured price per unit |
| **Tax** | Auto-applied based on item's tax configuration |
| **Discount** | Optional, percentage or fixed amount |
| **Total** | Auto-calculated |

## Adjusting a Bill

Bills can be modified before they are finalized:
1. Open the bill from **Billing > View Bills**.
2. Click **Edit**.
3. Modify items, quantities, or prices.
4. Save changes.

Once finalized (payment received and settled), bills are locked for editing. Contact support for corrections.

## Printing & Sharing

- **Print** — Bill opens as a PDF with the organization's configured letterhead.
- **WhatsApp** — Send the bill PDF to the patient's WhatsApp number.
- **Email** — Send to the patient's registered email.

## Payment Settlement

1. After generating the bill, record payment:
   - **Cash** — Enter amount received.
   - **UPI/Card** — Record transaction reference.
   - **Advance Adjustment** — Apply any existing advance payment.
2. Any remaining balance is tracked as "due."
3. The patient status shows "Discharged But Dues Not Cleared" in IPD until fully settled.

## FAQ

**Q: Can I split a bill between patient and TPA?**
A: Yes. Mark items as TPA-payable vs patient-payable during bill creation. Two invoices can be generated.

**Q: How are refunds handled?**
A: Refunds are processed through the Advance Transaction module in reverse. Contact support for refunds on finalized bills.

**Q: Can I add a custom charge not in the item list?**
A: Yes. Use the "Miscellaneous" item and add a description and amount. Or add the item to the Accounts Master for future use.