HMIS module
Hospital billing software
built from the clinical record.
Revenue leaks where the bill is assembled by hand. When investigations, pharmacy, bed days and procedures are already recorded in the same system, the bill is a query — not a reconstruction someone does at discharge.
In short
Hospital billing software produces and settles the charges for a patient episode: the consultation, investigations, medicines, bed days, procedures and consumables, plus the payments, outstanding receivables and any insurance or TPA claim against them. In Polynexus HMIS billing reads from the clinical and pharmacy records directly, which is what keeps a charge from being missed.
Capabilities
What the billing module covers
Bills & payments
Bill lifecycle from raise to settlement, with payments recorded against the bill rather than in a parallel cash book.
Records: Bill, Payment.
Receivables
Outstanding amounts tracked as records, so what is owed — and by whom — is readable at any point rather than compiled at month end.
Records: Receivable.
TPA & insurance
TPA company records, pre-authorisation requests raised and tracked before treatment, and insurance claims filed against the admission they belong to.
Records: TPACompany, PreAuthRequest, Claim, InsuranceClaim.
Charges from clinical activity
Investigation orders, dispensed medicines, bed allocation and theatre records already exist in the system, so the bill is assembled from them instead of from a separate charge slip.
Encrypted patient identifiers
Patient name and phone are stored encrypted at field level and decrypted by the API for authorised callers, so billing tables do not hold readable contact data.
Expenses & ledger
The finance module holds an expense ledger with an approval step, keeping outgoing spend in the same system as incoming revenue.
Records: Expense, Ledger.
Workflow
How a bill comes together
- 01
Charges accrue as care happens
The consultation, each investigation order, each dispensed medicine, each bed day and each procedure is recorded when it occurs — by the person doing it, in their own module.
- 02
Pre-authorisation where a payer is involved
For insured and TPA cases, a pre-authorisation request goes to the payer against the admission, so approval status is attached to the case rather than tracked on email.
- 03
The bill is assembled
At discharge or at the end of an outpatient visit the bill is built from those accrued records, which is why a missed charge has to be a missing clinical record rather than a missing note.
- 04
Payment and receivable
Payments are recorded against the bill; whatever is unpaid becomes a tracked receivable rather than an entry in someone’s follow-up diary.
- 05
Claim and settlement
Where a claim applies, it is filed against the same admission and followed through to settlement, with the shortfall visible against the receivable.
- 06
Reporting
Doctor revenue, revenue by source and the daily MIS come out of the settled data, so financial reporting and clinical reporting are describing the same events.
Reporting
What finance gets out of it
- Doctor revenue — what each consultant generated, from real billed activity.
- Revenue by source — cash, insurance, corporate, camp and campaign-originated revenue separated.
- Daily MIS — a daily operational and financial summary, with a preview before it is logged.
Because the hospital CRM shares the same database, revenue can be attributed back to the campaign, camp, corporate client or referring doctor that produced the patient — which is the part most hospitals cannot currently do.
FAQ
Hospital billing — common questions
- How does hospital billing software avoid missed charges?
- By building the bill from the clinical record instead of from a separate charge sheet. Investigations raised in the consultation, medicines dispensed from pharmacy stock, bed days from the actual allocation and procedures from the theatre record are already in the system, so the bill is assembled from what happened rather than from what someone remembered to write down.
- Does it handle TPA and insurance claims?
- Yes. TPA companies are held as records, pre-authorisation requests are raised and tracked against the case, and insurance claims are filed and followed up against the same admission the treatment sits on.
- Can we see outstanding money by patient and by payer?
- Receivables are tracked as records, so outstanding amounts can be read by patient, and revenue-by-source reporting separates cash, insurance, corporate and camp-originated revenue.
- Is patient contact data protected in billing records?
- Patient identifiers such as name and phone number are stored encrypted at the field level and decrypted by the API layer for authorised users, so the underlying billing tables do not hold readable patient contact details.
- Does it cover hospital expenses as well as income?
- Yes — the finance module holds an expense ledger with an approval step for outgoing spend, alongside receivables, so both sides of the hospital’s money sit in the same system.
See a bill assembled from live clinical data
We will run a visit through consultation, investigations and pharmacy, then produce the bill and the claim — on your tariff structure.