---
title: "Billing Overview"
description: "Overview of NICE HMS billing system — six voucher groups covering invoices, purchases, receipts, payments, contra entries, doctor expenses, stock adjustments, and the voucher audit workflow."
date: 2026-07-19
lastModified: 2026-07-25
category: "billing"
author: "Dr. Umesh Bilagi"
beta: false
---

## Overview

NICE HMS billing uses a voucher-based accounting system. Every financial transaction — patient billing, vendor purchases, cash receipts, bank deposits, fund transfers — is recorded as a **voucher** with a debit (Dr) and credit (Cr) side. There are 17 voucher types organized into six logical groups.

## Voucher Groups

### 1. Invoice — Patient Billing

Vouchers that record revenue from patients and payers.

| Type | Purpose |
|------|---------|
| INVOICE | Patient invoice (OPD, IPD, pharmacy, lab) |
| INVOICE_P | Pharmacy-specific patient invoice |
| CREDIT_NOTE | Credit note against a patient invoice (refund/reduction) |
| CREDIT_NOTE_P | Pharmacy-specific credit note |
| ESTIMATE | Provisional invoice (pre-billing estimate) |

Created from **Accounts > Invoice** (`/admin/accounts/invoice/`). See [Bill Transaction](/docs/bill-transaction).

### 2. Purchase — Vendor/Supplier

Vouchers that record purchases from suppliers and vendors.

| Type | Purpose |
|------|---------|
| PURCHASE | Hospital purchase (medicines, supplies, equipment) |
| PURCHASE_P | Pharmacy-specific purchase |
| DEBIT_NOTE | Debit note against a purchase (return/reduction) |
| DEBIT_NOTE_P | Pharmacy-specific debit note |

Created from **Accounts > Hospital > Purchase** or **Accounts > Pharmacy > Purchase** (`/admin/accounts/bill/create`). See [Purchase](/docs/purchase).

### 3. Receipt & Payment — Cash/Bank

| Type | Purpose |
|------|---------|
| RECEIPT | Money received (patient payment, advance, any inflow) |
| PAYMENT | Money paid out (vendor payment, expense, refund) |

Created from `/admin/accounts/recive-pay/` and `/admin/accounts/vendor-recive-pay/`.

### 4. Contra — Fund Transfers

| Type | Purpose |
|------|---------|
| CONTRA | Transfer between accounts (e.g., cash to bank) |
| CONTRA_B | Contra variant (bank deposit) |

Created from **Accounts > Contra** (`/admin/accounts/contra/`). See [Contra Transaction](/docs/contra-transaction).

### 5. Doctor Expense — Doctor Journals

| Type | Purpose |
|------|---------|
| DOCTOR_EXPENSE_BOOK | Record a doctor expense/commission |
| DOCTOR_EXPENSE_CANCEL | Reverse a previously booked doctor expense |

Created from **Accounts > Doctor Expense Booking** (`/admin/accounts/journal-doctor/`).

### 6. Stock — Inventory Adjustments

| Type | Purpose |
|------|---------|
| PHYSICAL_NEGATIVE | Stock deduction (damaged, expired, lost) |
| PHYSICAL_POSITIVE | Stock addition (found, correction) |

Triggered per-item from Item Management. See [Item Management](/docs/item-management).

## Supporting Flows

### Advance Transaction

Advance payments from patients or TPAs are recorded separately and adjusted against final invoices at settlement. See [Advance Transaction](/docs/advance-transaction).

### Voucher Audit

Every voucher goes through an audit workflow with two states: **Waiting** (pending review) and **Accepted** (reviewed). The Audit tool at the bottom of the Accounts page lets you query vouchers by type, date range, and audit state, then toggle their status in bulk. See [Voucher Audit](/docs/audit).

## Accounts Page Navigation

| Section | Links |
|---------|-------|
| **Contra** | User Cash, Deposit To Bank |
| **Pharmacy** | Purchase (PURCHASE_P), Debit Note (DEBIT_NOTE_P) |
| **Hospital** | Purchase (PURCHASE), Debit Note (DEBIT_NOTE) |
| **Doctor Expense Booking** | Book Expense, Reverse Expense |
| **Voucher Audit** | Query by type + audit state |

## How It All Connects

```
Accounts Master (chart of accounts)
       ↓
Item Management (billable items with prices)
       ↓
Patient Registration → Encounter → Services rendered
       ↓
Invoice (patient bill) ← Items from Accounts Master
       ↓
Receipt (payment collected) ← Advance adjusted → Final settlement
       ↓
Contra (fund transfer between accounts, if needed)

Purchase (vendor bill) → Payment (vendor paid) → Debit Note (returns)
       ↓
Stock adjustments (physical count corrections)
       ↓
Voucher Audit (review & accept every transaction)
```

## Key Concepts

### Accounts Master

All debit/credit entities (OPD, IPD, CASH, BANK, VENDOR, etc.) are defined in the Accounts Master. See [Accounts Master](/docs/accounts-master).

### Items

Medicines, consumables, services, and procedures are managed in Item Management and linked to accounts. See [Item Management](/docs/item-management).

### Cash Access

Daily cash-in and cash-out management, separate from patient billing. See [Cash Access](/docs/cash-access).

### GST Compliance

NICE HMS supports all Indian tax types:
- **IGST** — Interstate supplies (5%, 12%, 18%, 28%)
- **CGST + SGST** — Intrastate supplies
- **CST** — Central Sales Tax (2.5%, 6%, 9%, 14%)

Tax is configured per item in the Accounts Master and applied automatically.

## Related Guides

- [Bill Transaction](/docs/bill-transaction) — Patient billing (invoices, credit notes)
- [Advance Transaction](/docs/advance-transaction) — Advance payments and adjustments
- [Contra Transaction](/docs/contra-transaction) — Internal fund transfers
- [Purchase](/docs/purchase) — Vendor purchases and debit notes
- [Voucher Audit](/docs/audit) — Reviewing and accepting vouchers
- [Accounts Master](/docs/accounts-master) — Chart of accounts
- [Cash Access](/docs/cash-access) — Daily cash management
- [Item Management](/docs/item-management) — Billable items and stock