Emergency services and billing

What this does

Once a patient has been triaged and treated in the Emergency Ward, the doctors and staff record the services provided (procedures, medications, tests, consultations). Usystems combines these services into a single invoice for the patient or their guarantor, and routes the charges to the appropriate financial accounts.

Before you start

• The patient has been triaged and has an active medical case
• Services have been documented by the treating doctor or clinical staff
• You have permission to generate and edit invoices
• The patient's contact type and default payment method are configured

Steps

1. Open the patient's medical case

   Go to Medical Cases Open in Usystems and select the emergency case for the patient.

2. Review the services delivered

   The case shows all services recorded by doctors and nurses during the visit. Services may include:

   • Doctor/specialist consultations
   • Procedures (wound care, intubation, catheterization, etc.)
   • Medications and injectables
   • Diagnostic tests (lab, imaging, ECG)
   • Room and bed charges
   • Any supplies or equipment used

3. Generate the emergency invoice

   From the medical case, click Generate Invoice or Create Bill. The system automatically collects all recorded services and creates a single financial document with:

   • Patient/contact name and ID
   • Service itemization (date, description, quantity, unit price)
   • Subtotal before discounts or adjustments
   • Tax (if configured for your facility)
   • Final amount due

4. Review pricing and apply adjustments

   Before finalizing, verify:

   • Service prices are correct (match your facility's rate card)
   • Any urgency-based surcharges (if configured) are applied
   • Discounts or waivers (charity cases, government subsidies) are applied if applicable
   • The patient's advance or prepayment (if any) is deducted

5. Select payment method and finalize

   Choose how the patient is expected to pay:

   • Cash: immediate payment expected at the time of discharge
   • Credit account: bill the patient's contact account for later settlement
   • Insurance: bill to the patient's insurance provider
   • Advance balance: apply a prepayment or advance already on file

   Click Save & Finalize or Generate Receipt. The invoice is now locked and a copy is given to the patient.

6. Post to financial records

   The invoice automatically:

   • Posts the service charges to the patient's account (Accounts Receivable)
   • Posts the revenue to the appropriate medical service accounts (e.g., Emergency Consultation, Surgical Procedure, Lab Services)
   • Records any payments received
   • Updates patient and ward reports

Accounting impact

• Revenue is recognized: service amounts are debited to Accounts Receivable (or the payment account if cash/insurance), and credited to Medical Service Revenue.
• Supplies and procedures may be credited from Inventory or directly from Expense accounts, depending on your facility's configuration.
• Taxes (if applicable) are collected in a Tax Payable account.
• Ward costs (room, bed, staff time) may be allocated to the Emergency Ward Cost Center.

Tips & common mistakes

• Do not create the invoice until the patient is discharged. Services may still be added during the visit; creating the invoice too early will require adjustments or re-invoicing.
• Verify the patient's contact type is correct. If the patient is misclassified (e.g., listed as a vendor instead of a patient), the invoice will post to the wrong account.
• Check urgency surcharges before finalizing. Some facilities add a fee for emergency triage—confirm this is intentional and correctly applied.
• Issue a receipt on discharge. Even if the patient is not paying immediately, a receipt or discharge summary serves as the invoice and is required for medical records.