Patient Billing & Cashier Settlement

1. Overview & Business Value#

This comprehensive operational guide details the architecture, business workflows, configuration parameters, and execution steps for Patient Billing & Cashier Settlement within SmartERP.

Guide to consolidating clinical service charges, issuing fiscal cash receipts, managing pre-payments, and reconciling daily cashier drawers.

{screenshot:patient-billing-and-cashier-settlement-overview-dashboard}

2. Prerequisites & Security Access Groups#

• Required Modules: smarterp_healthcare, smarterp_clinical_core, smarterp_pharmacy
• Security Groups:
  • Healthcare Receptionist (Technical ID: smarterp_healthcare.group_medical_receptionist)
  • Physician / Attending Doctor (Technical ID: smarterp_healthcare.group_medical_doctor)
  • Pharmacy Dispenser (Technical ID: smarterp_healthcare.group_medical_pharmacist)
• Master Data Dependencies: Patient master registry (Medical Record Number - MRN), EFDA drug formulary, Ethiopian Ministry of Health (MoH) HMIS disease codes, and EHIS insurance tariffs.

3. Step-by-Step Configuration & Execution#

Step 1: Navigating to the Module Interface#

1. Log into your SmartERP instance at https://smarterp.et/odoo.
2. Open the main App Switcher (grid icon in the top-left corner).
3. Select the Healthcare app icon.
4. From the top navigation bar, open Healthcare → Clinical Dashboard → OPD Triage / Inpatient ADT / EMR / Pharmacy Dispensing.

{screenshot:patient-billing-and-cashier-settlement-app-switcher-navigation}

Step 2: Creating and Parameterizing Records#

1. Click the New button in the top-left control panel.
2. Complete the mandatory fields in the record form:
   • Medical Record Number (MRN) (Mandatory): Unique national health identifier or generated hospital record code
   • Patient Demographics (Mandatory): Full legal name, gender, date of birth, and Kebele residential location
   • Encounter Type (Mandatory): Outpatient (OPD), Inpatient (IPD), Emergency, or Triage consultation
   • Attending Physician (Mandatory): Licensed healthcare practitioner responsible for clinical encounter
3. Configure optional operational parameters and localized tags as required:
   • Insurance Provider & Policy (Optional): EHIS CBHI/SHI policy or corporate credit contract
   • Triage Vital Signs (Optional): Blood pressure, pulse rate, respiratory rate, temperature, and SpO2
   • ICD-11 / HMIS Diagnosis Code (Optional): Standardized diagnosis category for statutory health reporting
4. Click the Save icon in the control bar to commit the record.

{screenshot:patient-billing-and-cashier-settlement-record-creation-form}

Step 3: Validating and Processing Transactions#

• State Transitions: Execute operational state progression (Reception / Triage → Consultation → Lab / Radiology → Prescription → Billing / Discharge).
• Ledger & System Impact: Patient billing registers medical service revenue, debits patient or insurance accounts receivable, and debits pharmaceutical inventory upon prescription dispensing.
• Audit Verification: Automated recording of author ID, timestamp, and immutable revision history.

{screenshot:patient-billing-and-cashier-settlement-transaction-processing-state}

Unified Patient Billing Folio#

SmartERP continuously aggregates chargeable clinical activities into the patient's open billing folio:

• Outpatient registration and doctor consultation fees.
• Diagnostic laboratory tests and pathology fees.
• Radiology and ultrasound imaging charges.
• Pharmacy medications and surgical supplies dispensed.
• Inpatient bed days, nursing care, and theatre procedure charges.

Outpatient Cash Settlement & Fiscal Receipts#

1. Open Healthcare > Cashier > Billing Queue.
2. Enter or scan the patient's MRN (CL-2026-001092).
3. The screen displays all unbilled orders pending payment.
4. Select payment method:
   • Cash (ETB): Enter amount tendered; system computes change.
   • Telebirr: Generate dynamic QR code or send USSD push payment to patient mobile.
   • CBE Birr / Debit Card: Process via POS card terminal.
5. Click Post Payment & Issue Fiscal Receipt.
6. The connected Ethiopian fiscal cash register / fiscal printer prints the official FS Fiscal Receipt containing the fiscal device serial number and QR validation code.

Inpatient Advance Deposits & Interim Invoicing#

For hospitalized patients:

1. Upon admission, the cashier records an Inpatient Advance Deposit (e.g., 10,000.00 ETB).
2. The deposit posts as a customer credit on the patient's sub-ledger (account.payment).
3. As daily bed charges and medications accrue, the system tracks net available deposit balance.
4. If the deposit falls below the required threshold (e.g., $< 2,000.00\, ETB$), an automated SMS notification alerts the family to top up the admission account.

Daily Cashier Drawer Reconciliation#

At the end of every 8-hour cashier shift:

1. Navigate to Healthcare > Cashier > Daily Drawer Close.
2. Enter physical cash count by denomination (100 ETB, 200 ETB notes).
3. The system compares physical cash against electronic register receipts: $$\text{Variance} = \text{Physical Cash Count} - \text{System Calculated Cash}$$
4. Reconcile electronic payments (Telebirr, CBE Birr, card merchant receipts).
5. Print the Daily Cashier Balance Summary and hand over proceeds to the hospital chief vault.

4. Advanced Configuration Points#

• Automated Actions & Scheduled Tasks (Crons):
  • Healthcare: Generate daily MoH HMIS aggregate tally (smarterp_healthcare.ir_cron_hmis_sync): Runs daily at 23:00 to prepare DHIS2 health data summaries
  • Pharmacy: Flag expiring EFDA medicine batches (smarterp_healthcare.ir_cron_fefo_expiry): Runs daily at 06:00 to alert dispensers of lots expiring within 60 days
• Custom Print Templates & Reports:
  • Official Patient Encounter Summary & Medical Certificate
  • Electronic Prescription Order Form (Model 19 Compliant)
  • Ethiopian Health Insurance Service (EHIS) Claim Dossier
  • Daily MoH Outpatient / Inpatient Morbidity Tally Sheet
• Multi-Company Rules: Record-level security isolation under Company 1 (Ashewa Technology Solutions S.C.), preventing cross-company ledger leakage across parent and subsidiary legal entities.

5. Comprehensive Troubleshooting Matrix#