Features
Billing & Claims
From service charges to insurance claims, without a second system.
Billing in a health facility spans three distinct payer types — cash patients, insurance scheme patients, and NHIF members — and all three can present on the same day. Health360 generates the invoice from the services and items recorded during the visit, so billing staff are confirming what was done rather than keying it from memory. Cash and mobile money payments are recorded immediately, insurance and NHIF claims are built from the visit data and submitted from within the system, and co-payment amounts are calculated and collected at the front desk. Statements give patients and schemes a clean record of every transaction.
- Auto-generated service invoice
- Cash & mobile money payments
- Insurance scheme billing
- NHIF claims
- Co-payment collection
- Patient statements
- 1Generate invoices from the visit record
- 2Accept cash and mobile money at the desk
- 3Bill insurance schemes directly
- 4Raise and track NHIF claims
- 5Calculate and collect co-payments
- 6Issue patient statements
Generate invoices from the visit record
When a patient’s visit is complete, billing opens the encounter and the invoice is pre-populated with the consultation fee, any lab tests ordered, drugs dispensed, and procedures performed. Billing staff review and confirm the lines rather than re-entering them, so errors from retyping are eliminated and the invoice reflects the actual care provided.
Accept cash and mobile money at the desk
Cash patients pay at the billing counter where the cashier records the amount received and the system calculates change. Mobile money payments are recorded with the transaction reference number. A receipt is printed or sent by SMS immediately. All payment methods are logged against the invoice so the daily collections report separates cash from mobile money without manual sorting.
Bill insurance schemes directly
For patients covered by employer insurance schemes, the invoice is tagged to the scheme and the patient’s membership number at billing. The scheme’s claim is accumulated in the claims register and can be submitted in a batch at the end of the month with all the supporting visit data already attached. Scheme-specific price lists are configured in advance so the correct tariff is applied automatically.
Raise and track NHIF claims
NHIF patient visits are flagged at registration and the claim is built from the visit data using the NHIF benefit codes configured in the system. Claims are reviewed and submitted from the billing module, and the claim status — submitted, queried, paid, or rejected — is tracked against each visit so the facility knows exactly which claims are outstanding and which require resubmission.
Calculate and collect co-payments
Insurance and NHIF patients often owe a co-payment at the point of service. Health360 calculates the co-payment from the scheme’s benefit rules and displays the amount the patient owes so billing can collect it before the patient leaves. The co-payment is recorded separately from the claim amount on the invoice, keeping the reconciliation clean.
Issue patient statements
For patients with running accounts or outstanding balances, a statement can be generated at any time showing every invoice, payment, and balance over a date range. The statement is printable or sendable by email, giving the patient a clear record of what they owe and what they have already paid without a manual calculation.