Purpose of the Module

This module provides end-to-end management of medical services and financial settlements with insurance providers, enterprises and private patients. It ensures transparency, accuracy and scalability across all service-related workflows. 📊⚖️

Service Accounting

  • Accurate registration of provided services
  • Automatic contract selection
  • Flexible discounts and loyalty programs

Contract Management

  • Private, insurance and corporate contracts
  • Policy holders and participants tracking
  • Automated financial calculations

AI Analytics

  • Detection of anomalies in service assignments
  • Physician efficiency and performance insights
  • Demand and workload forecasting

Medical Services Catalog

The pricing catalog is dynamically managed and supports seamless updates without losing historical data - ensuring financial continuity and auditability. 📄🔢

Service Parameters

  • Service code and name
  • Service group and category
  • Links to procedures and lab tests
  • Included complimentary services
  • Standard consumables and materials

Dynamic Lifecycle Management

  • Add new services instantly
  • Modify pricing and parameters
  • Archive outdated services without deletion

Contract-Based Pricing Logic

Contracts define pricing rules for different patient categories. The system supports three primary contract types:

Internal (Self-Pay)

  • Standard pricing for private patients
  • Direct payments
  • Single active contract per organization

Public / Insurance

  • Insurance company integration
  • Reusable contract templates
  • Automatic service eligibility validation

Corporate & Private Insurance

  • Partial co-payments
  • Flexible pricing models
  • Policy and participant management

A patient may be associated with multiple contracts - the system automatically selects the most optimal pricing logic. 🔄🤖

Service Registration & Tracking

Each assigned service is recorded with full traceability - including physician, pricing rules, discounts, execution status and timestamps.

Captured Data

  • Assigned medical service
  • Ordering and performing staff
  • Assignment and completion dates
  • Service cancellation tracking
  • Discounts and bundled packages

Advanced Capabilities

  • Automatic price resolution from contracts
  • Complete service history per patient
  • Filtering by period, physician or department

Billing & Payments

Payments can be processed via insurance providers or directly by patients. The system automatically distributes amounts according to contract rules. 💳📊

  • Invoice generation for insurers and enterprises
  • Direct payments outside contracts
  • Partial and split payment support

Reporting & AI Insights

A powerful reporting engine combined with AI analytics provides deep visibility into operational and financial performance. 🔍⚡

Standard Reports

  • Financial summaries
  • Provided services overview
  • Contract-based reports

AI-Powered Reports

  • Anomaly detection in service assignments
  • Identification of operational errors
  • Predictive demand forecasting

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