Bill Transaction

Overview

Bill Transactions are the patient-facing side of NICE HMS billing. Every service rendered during a patient encounter — consultation, lab test, medicine, procedure, room charge — is recorded as an invoice and settled via a receipt (payment received) or payment (refund returned). In the code, this is the Invoice component; "Bill" is the term used throughout the UI and this guide.

Invoices are always linked to a patient and encounter. The credit side (sales account) is auto-detected based on the encounter type: OPD, IPD, or Pharmacy.

Voucher Types

Patient billing uses these voucher types:

These are created from the Invoice page (/admin/accounts/invoice/create). Payment settlement uses RECEIPT and PAYMENT vouchers (see Payment Settlement below).

Creating an Invoice

1. Open a patient encounter (OPD, IPD, or Pharmacy).
2. Navigate to the billing/invoice option for that encounter.
3. The invoice page loads with these query parameters:

Auto-Detection

The system automatically determines the sales account based on context:

Form Fields

Item Sources

Items can come from two sources:

• Catalog — Items filtered by category: Hospital/Lab/Radiology for INVOICE, Pharmacy items for INVOICE_P
• ServiceRequest — When servcieRequestid is provided, items are pre-loaded from the linked prescription with tariff-based rates

Tax Calculation

Tax is computed per item as CGST + SGST (intrastate). The tax rates are configured on each item in the Accounts Master. The formula:

itemAmount = quantity × salePrice
discounted  = itemAmount × (100 - discount%) / 100
gstAmount   = (cgst% × discounted) + (sgst% × discounted)
total       = discounted + gstAmount

OPD Billing

For outpatient encounters:

• Credit account is auto-set to OPD
• Items are loaded from Hospital, Laboratory, Radiology, and Blood Bank categories
• One invoice per encounter — covers consultation, tests, and procedures done during that visit

IPD Billing

For inpatient encounters:

• Credit account is auto-set to IPD
• Charges accumulate across the stay: room charges (daily), doctor visits, procedures, medicines, lab, radiology
• Consolidated into an invoice at discharge, or interim bills during the stay (see below)

Interim & Final Bills

Every encounter has an intrimOrFinal property for TPA/insurance billing. While the toggle is available on any encounter, it is primarily designed for IPD stays where insurers need partial bills before discharge.

The intrimOrFinal property lives on the Encounter object. To toggle it:

1. Open the patient's billing page.
2. Use the Set Bills as Interim / Set Bills as Final button.
3. The encounter's bill status updates and reflects in the EncounterWise balance table.

EncounterWise Balance Table

The balance table shows all encounters for a patient with columns:

Access the balance table from the patient's billing view and click Get Encounter Balances.

Pharmacy Billing

Pharmacy invoices use INVOICE_P and CREDIT_NOTE_P:

• Credit account = Pharmacy
• Items filtered from the Pharmacy category only
• Prints with the pharmacy letterhead (configurable in Organization Settings)
• Integrates with pharmacy inventory — dispensed items update stock

Credit Notes

When a patient needs a refund or an invoice needs correction:

1. Create an invoice with vouchertype CREDIT_NOTE (or CREDIT_NOTE_P for pharmacy).
2. The form is the same as an invoice but with a red border (INVOICE = green).
3. After saving, the Return Payment button navigates to the receipt/payment page with vouchertype PAYMENT — money flows back to the patient.

Payment Settlement

After an invoice is created, record payment through the receipt/payment page (/admin/accounts/recive-pay).

Recording a Payment (RECEIPT)

1. After saving an INVOICE, click Record Payment.
2. The receipt page opens with vouchertype=RECEIPT and invoiceid=<new invoice>.
3. Fill in:

4. Submit. This creates a RECEIPT voucher: debit to cash/bank, credit to patient.

Processing a Refund (PAYMENT)

1. After saving a CREDIT_NOTE, click Return Payment.
2. The payment page opens with vouchertype=PAYMENT.
3. Enter the refund amount and the cash/bank account the money comes from.
4. Submit. This creates a PAYMENT voucher: debit to patient, credit to cash/bank.

Invoice-Wise Tracking

When payment is recorded via the Record Payment button from an invoice, the receipt is linked to that specific invoice. The system tracks:

• invoiceBalance = invoice amount − sum of linked receipts
• An invoice is settled when its balance reaches zero

Advance Adjustment

If the patient has an advance payment on file, it can be adjusted against the invoice during settlement. See Advance Transaction.

Printing & Sharing

After saving an invoice or receipt:

1. A Print section appears with letterhead options.
2. Select the appropriate letterhead:
   • Patient letterhead — for OPD and IPD invoices
   • Pharmacy letterhead — for INVOICE_P and CREDIT_NOTE_P
3. Click to generate and download the PDF.

Invoices can also be shared via WhatsApp or email from the patient's record.

FAQ

Q: Can I split a bill between patient and TPA? A: Yes. Select the TPA as the Payor when creating the invoice. The debit account will be the TPA instead of Self. You can also create separate invoices for patient-payable vs TPA-payable items.

Q: How are refunds handled? A: Create a CREDIT_NOTE for the items being refunded, then process a PAYMENT from the receipt/payment page to return the money.

Q: When should I use Interim vs Final? A: Use Interim for partial bills during a long IPD stay (e.g., weekly TPA claims). Set to Final at discharge when the bill is complete and ready to lock.

Q: Can I add a custom charge not in the item list? A: Yes. Add a Miscellaneous item in Item Management first, then select it on the invoice. See Item Management.

Q: How do I correct an invoice after it is saved? A: Only an admin can edit an invoice, and only when the encounter is still in-progress. If editing is not possible (wrong role or encounter closed), create a CREDIT_NOTE to offset the incorrect amount and issue a new invoice.

Q: Does creating an invoice update stock? A: Pharmacy invoices (INVOICE_P) update medicine stock. Hospital invoices update store inventory if the items are linked to a store account.