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As a cashier, I want the system to automatically generate consultation fees based on the patient visit
When a Visit is started, the system checks the patient’s visit history for the last 7 days
This is currently in place, but the system does not check the days
Can bills be waived without authorizations?
If the patient has NO visits within the last 7 days, automatically add a “Consultation Fee” item to a new bill associated with the encounter
No visit history rule is applied at the moment (needs to be done at the implementation level)
Bill status is set to UNPAID” when auto-generated
high
Payment Status Visibility in Clinical Workflow ❌
As a healthcare provider (triage nurse, clinician, lab technician, pharmacist), i want to see the patient’s payment status displayed prominently so that i can make informed decisions about care sequencing while maintaining clinical continuity
Payment status should NOT block access to clinical forms to prevent delays in care delivery
Ensure providers can view payment details status (UNPAID, PARTIALLY PAID or PAID) within the patient chart without having to navigate away
As a System Admin, I want the system to handle recent visits (within 7 days) without generating a new consultation bill, so that we don’t overcharge patients for follow-up care
System to check for previous visits within the last 7 days upon patient check-in
If a recent visit exists:
No new consultation bill is created
Payment status displays: PAID
Patient bypasses the cashier and proceeds directly to triage/consultation
If the clinician orders New services (lab tests or medications) during the visit:
The system creates a bill for these new services
Payment status changes to UNPAID
Patient must go to the cashier to pay before lab/pharmacy services
If NO new services are ordered:
Payment status remains marked as PAID
Patient completes visit without needing to see the cashier
What if the patient did not pay during the initial visit?
As a system Admin, I want to configure which services are free and which visit types bypass payment, so that HIV/TB programs and emergency care can proceed without cashier interaction
The system should support “Payment Bypass” based on
Patient Category = HIV/TB
All HIV-related consultations are free
HIV+TB services are free
HIV laboratory tests are free
Which specific visit type - need to be specified? What rule is being used? Is it registration with specifics
As a Cashier/Receptionist, I want to process consultation or lab orders or medication fees payments quickly so that clinical care can proceed without delays
The payment interface should display the bill item PENDING payment
Support multiple payment methods ~ Cash, Mobile, Card, Insurance
Upon successful payment, the bill status should be updated to “PAID” immediately
As a Cashier/Receptionist, I want to edit existing bills to add or adjust charges, so that i can correct errors or add services that were ordered after initial billing
Authorized users (cashiers/receptionists) can edit bills
Bill editing should allow
Adding new line items (services, medications, etc)
Modifying quantities of existing items
Removing incorrect line items
When the bill is edited:
The system should recalculate the total amount
Update payment status (PAID, PARTIALLY PAID, or UNPAID)
Timestamp and the user who made the edit should be captured in the audit log
Bill editing reasons should be tracked (e.g Additional services ordered, Pricing correction, Service removed/cancelled) - hard to implement
Audit log is essential
If the bill was already PAID, but the amount increases
Option 1 is to just have separate bills ~ system creates a NEW bill, 2 separate receipts are issued
Option 2 is to have a single consolidated bill ~ Cashier edits the existing bill to add
As an Administrator, I want a formal refund workflow so that we can accurately return funds when a paid service cannot be provided due to technical or logistical failures.
Used for instances where service delivery is interrupted after payment is made (e.g., broken equipment, lack of reagents)
System must support transitioning an invoice status from PAID → REFUND → REFUNDED.
Add a specific "Request Refund" button to a bill with a PAID status
Status for a refund requested is needed
All refund requests require Administrative Approval before funds can be officially released or the status updated to "Refunded."
As an Administrator, I want to apply governed and traceable discounts to patient bills so that we can support facility-level financial needs while maintaining full auditability and preventing informal practices.
The ability to initiate or approve discounts is restricted to Admin roles only and must be configurable (enabled/disabled) at the facility level
Every discount must capture: (this is different from functionality in place)
Initiator and Approver IDs
Percentage or specific amount
Mandatory justification/motif - this is currently missing
Date and time stamp
Final invoices/receipts must clearly display the original price, the discount applied, and the final amount.
As a Cashier, I want to allocate payments to specific bill items rather than prorating across the total, so that there is clear visibility on which services are paid versus unpaid
Partial payments must be allocated to specific bill items selected at the time of payment
The suggestion is to have only those items that will be paid - way too complicated for partial payments
Currently, we don't have a way to have multiple bills on the same day - when we do automatic bills, which bills do those items belong
Only items explicitly paid should be marked as PAID; all other remaining items stay as UNPAID / PENDING
high
Outstanding Bills Tracking ❌
As a Cashier, I want to clearly identify and track unpaid services from previous visits so that patients can complete payments on subsequent days.
Unpaid items must remain outstanding
Enable clear tracking and visibility of outstanding bill items at the patient level across all historical visits
Cashiers must have the ability to complete payments for these outstanding items during subsequent visits
high
Bill Reopening ❌
As an Administrator, I want to reopen and modify previously finalized bills so that I can correct billing errors without creating new bills.
Used for instances where billing errors are discovered after a bill has been finalized (e.g., incorrect charges)
System should support transitioning a bill status from CLOSED → REOPENED → CLOSED
All bill reopening actions ~ requires Administrative Approval before the bill can be edited
high
Patient Billing Information ✅ ❌
As a cashier, I want to capture complete patient billing information so that I can generate accurate invoices.
Patient Identification ~ Name, Gender, ID
Item(s) billed
Quantity for each item
Unit price for each item
Discount amount ❌
Discount reason/justification ❌
Total amount due
Date
high
Billing Metrics
Total number of items ordered/billed
As a billing administrator, I want to view the total number of items ordered/billed so that I can track the total number of items ordered across different time periods
Count all medical items that have been added to invoices, regardless of payment status
Total value based on the master price list
Users must be able to select Start Date and End Date using a date picker to generate reports for a specific period
The default view should show current-day metrics
Filter by department (Consultation, Lab, Pharmacy, etc.)
The report should include an Export CSV function for further auditing and external accounting
CSV export must include all detailed data (not just summary)
Item name, Quantity, Unit Price, Total Amount Billed
high
Number of items successfully paid for
As a billing administrator, I want to view the total number of items ordered/billed so that I can track the total number of items successfully paid for across different time periods
Count of all medical items that have been fully paid
Total cash/payments actually collected for the medical items
Users must be able to select Start Date and End Date using a date picker to generate reports for a specific period
The default view should show current-day metrics
Filter by department (Consultation, Lab, Pharmacy, etc.)
The report should include an Export CSV function for further auditing and external accounting
CSV export must include all detailed data (not just summary)
Item name, Quantity, Unit Price, Total Amount Paid
high
Number of items still awaiting payment
As a billing administrator, I want to view the total number of items ordered/billed so that I can track the total number of items awaiting payment across different time periods
Count of medical items with outstanding balances (partial or no payment)
The remaining unpaid amount for the medical items
Users must be able to select Start Date and End Date using a date picker to generate reports for a specific period
The default view should show current-day metrics
Filter by department (Consultation, Lab, Pharmacy, etc.)
The report should include an Export CSV function for further auditing and external accounting
CSV export must include all detailed data (not just summary)
Item name, Quantity, Unit Price, Total Amount Outstanding
