Commercial visits settlements - en example

The jHIS system supports payments for commercial visits, rehabilitation surgeries, operations, diagnostic examinations, vaccinations and rehabilitation cycles planned using packages.

Depending on the settings of clinic / ward payment can be realized after a visit / rehabilitation surgery / operatrion (post-pay) or before the visit / rehabilitation surgery / operation (advance payment). Payments for diagnostic examinations are encountered with issuing order for examinations and are realized before performing examinations. Payments are realized by the "Payment" tab in the patient card or by “Unrealized payments” functionality.

Post-pay can be realized when the visit / surgery / operation receives the "realized" status. Then in the patient payments tab appears unrealized payment. Payment may be realized by issuing a receipt or invoice. Fee can be contributed immediately or later. If payment is taken later, the bill (invoice or receipt) is displayed in the list of unpaid invoices with the possibility of noting the payment.

Payment in advance is done after appointing for visit / surgery / operation and before its realization. After appointing visit / surgery / operations, in the tab of patient payments appears unrealized payment. Payment may be realized by issuing a receipt or invoice. Fee can be accepted immediately or later. If payment is taken later, the bill (receipt or invoice) is displayed in the list of unpaid invoices with the possibility of noting the payment. If visit / surgery / operation has been realized without any changes in services planned for realization, it ends the payment process. If doctor realizing the visit / surgery / operation specifies that he has realized additional service / services that have not been planned while arranging visit / surgery / operation, then within payments tab of patient card there will appear new unrealized payment for additional service / services which is realized as post-pay. If visit / surgery / operation has not been realized or visit / surgery / operation has been realized and some of services have been realized with quantities different than planned (or have not been realized), then within payments tab of patient card there will appear unrealized payment (if patient has to pay more for a visit / surgery / operation) or overpayment (if patient is to receive return of whole or part of payment for a visit / surgery / operation). Taking of supplement pay can be realized by issuing correcting receipt or correcting invoice (depending on primary document whether it was receipt or invoice). Supplement pay can be taken immediately or later. If payment is taken later, the bill (correcting invoice or correcting receipt) is displayed in the list of unpaid bills with the possibility of noting the payment.Making return can be realized by issuing correcting receipt or correcting invoice (depending on primary document whether it was receipt or invoice). Return is realized in full amount at the moment of issuing of the bill.

Payment in advance for diagnostic examination is done after issuing order and marking visit as realized and before order realization. After issuing order, in the tab of patient payments appears unrealized payment. Payment may be realized by issuing a receipt or invoice. Fee can be accepted immediately or later. If payment is taken later, the bill (receipt or invoice) is displayed in the list of unpaid invoices with the possibility of noting the payment. If order is realized fully, it ends the payment process. If order has been realized partly (some examinations have been postponed to realization in future), then within payments tab of patient card there appears overpayment (patient is to receive return of part of payment for an order in the amount corresponding to non-realized examinations). Making return can be realized by issuing correcting receipt or correcting invoice (depending on primary document whether it was receipt or invoice). Return is realized in full amount at the moment of issuing of the bill.

Payment in advance for vaccination is done after issuing order and marking visit as realized and before order realization. After issuing order, in the tab of patient payments appears unrealized payment. Payment may be realized by issuing a receipt or invoice. Fee can be accepted immediately or later. If payment is taken later, the bill (receipt or invoice) is displayed in the list of unpaid invoices with the possibility of noting the payment. If order is realized fully, it ends the payment process. If order has been realized partly (some vaccinations have been postponed to realization in future), then within payments tab of patient card there appears overpayment (patient is to receive return of part of payment for an order in the amount corresponding to non-realized vaccinations). Making return can be realized by issuing correcting receipt or correcting invoice (depending on primary document whether it was receipt or invoice). Return is realized in full amount at the moment of issuing of the bill.

Payment for rehabilitation cycle planned using package can be realized only in advance after planning the cycle and before start of its realization. After planning the cycle within patient payments tab there appears underalized payment for the whole cycle. Payment may be realized by issuing a receipt or invoice. Fee can be accepted immediately or later. If payment is taken later, the bill (receipt or invoice) is displayed in the list of unpaid invoices with the possibility of noting the payment. Making changes within surgeries planned within the cycle (realization of additional surgeries, lack of realization of planned surgeries) does not cause financial implications – no corrections are generated so patient does not have to make surcharge nor he acquires overpayment. If patient resignes a cycle (so a package too) during its realization, then payment for visits awaiting for service in the moment of resignation becomes returnable to the patient (such visits are automatically canceled at the moment of cycle resignation), except that when paying for the whole cycle, patient paid amount with discount defined within the package, but resignation a package means, that visits already serviced should be treated as if they were serviced without using package ant it menas without doscount, so patient is entitled to obtain amount equal to the difference between package price and nominal price (without discount) of visits already serviced (marked ad realized / unrealized / canceled during package usage – before resignation). This case is prezented within the following example:

Patient has planned following surgeries:

3 surgeries x 100 zł, 3 surgeries x 70 zł, 3 surgeries x 50 zł (nominal prices)

He uses package with the following discount:

10%

Amount to be paid for the package is then:

3 * 100 zł * (100% - 10%) + 3 * 70 zł * (100% - 10%) + 3 * 50 zł * (100% - 10%) = 594 zł

At some time patient resignes a package. Let's assume that at the moment of resignation the following surgeries are already served (marked as realized / unrealized / canceled):

1 surgery x 100 zł, 2 surgeries x 70 zł, 2 surgeries x 50 zł (nominal prices)

It means that at this moment the following surgeries are waiting for service:

2 surgeries x 100 zł, 1 surgery x 70 zł, 1 surgery x 50 zł (nominal prices)

Nominal price of serviced surgeries is (patient would pay for surgeries without package using such prices):

1 * 100 zł + 2 * 70 zł + 2 * 50 zł = 340 zł

Amount to be returned to the patient is:

594 zł - 340 zł = 254 zł

If the above amount were negative, patient would not obtain any return.

Amount to be returned is divided proportionately to nominal prices of surgeries waiting for service:

2 surgeries x 100 zł / (100 zł + 100 zł + 70 zł + 50 zł) * 254 zł = 2 surgeries x 79.38 zł

1 surgery x 70 zł / (100 zł + 100 zł + 70 zł + 50 zł) * 254 zł = 1 surgery x 55.56 zł

1 surgery x 50 zł / (100 zł + 100 zł + 70 zł + 50 zł) * 254 zł = 1 surgery x 39.69 zł

which gives in total 254.01 zł (result of roundings). Because patient is entitled to obtain return at most 254 zł so one has to make corrections to the above amount so that total amount was not greater than the amount to be returned (254 zł). Corrections are arbitrary – let's assume we make correction of -0.01 zł to the third amount which gives:

2 surgeries x 79.38 zł

1 surgery x 55.56 zł

1 surgery x 39.68 zł

and in total 254 zł.

To issue vaild correcting invoice / correcting receipt one has to introduce artificial corrected discounts for particular surgeries that is:

2 x (100 zł - 79.38 zł) = 2 x 20.62 zł

1 x (70 zł - 55.56 zł) = 1 x 14.44 zł

1 x (50 zł - 39.68 zł) = 1 x 10.32 zł

When applying the above discounts, within the correcting invoice / correcting receipt there appears amounts for surgeries thar sum up to the amount to be returnerd to the patient. The above discounts are gross amounts. Net amounts required to issue correcting invoice / correcting receipt are calculated according to VAT rate from price list valid from the surgeries. If for any of gross amounts, net amount cannot be calculated, then one has to increase gross amount by 0.01 zł, 0.02 zł, 0.03 zł and so on trying to calculate net amount each time till reaching such a gross amount for which net amount could be calculated (for example: with VAT rate of 23% and gross amount of 113.03 zł, net amount cannot be calculated because by such VAT rate for net amount of 91.89 zł gross amount is 113.02 zł and for net amount of 91.90 zł gross amount is 113.04 zł and that's why gross amount of 113.03 zł should be increased by 0.01 zł and then net amount would be 91.90 zł).

For each visit waiting for service at the moment of package resignation, within patient payments tab there appears overpayment. Making return can be realized by issuing correcting receipt or correcting invoice (depending on primary document whether it was receipt or invoice). Return is realized in full amount at the moment of issuing of the bill.