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Financial Settings: Billing, Tax Configuration & Insurance Management

The Financial Settings module provides the infrastructure to manage your clinic's revenue cycle. From automated invoicing to complex insurance claims, these settings ensure your clinic is financially accurate, compliant with local regulations, and prepared for seamless reimbursement.

1. Billing​

This section defines how your clinic generates revenue and manages patient accounts.

  • Billing Cycles: Set up automated billing intervals (e.g., end-of-visit, monthly, or quarterly invoicing).
  • Fee Schedules: Manage your service pricing; you can create different "Price Books" for cash-paying patients versus those with specific insurance contracts.
  • Payment Terms: Define default grace periods for invoices and automated late-payment reminders.
  • Invoice Customization: Configure the layout and information displayed on patient invoices, including payment links and clinic bank details.

2. Tax Configuration​

Ensure your clinic remains compliant with local financial regulations by accurately setting up your tax rules.

  • Tax Rates: Configure VAT, GST, or local sales tax rates applicable to your region.
  • Service/Product Mapping: Define which services or medical products are taxable and which are tax-exempt (e.g., certain essential medical consultations).
  • Compliance Reporting: Set up tax grouping for easy export to your accounting software or government reporting portals.

3. Insurance Settings​

Simplify the claims process by centralizing your insurance partner information and coverage logic.

  • Payer Database: Store details for all supported insurance companies, including contact info, claim submission portals, and reimbursement policies.
  • Coverage Rules: Configure specific rules for insurance validation (e.g., checking policy validity and identifying "pre-authorization" requirements before certain procedures).
  • Claim Templates: Customize the standard CMS-1500, UB-04, or regional equivalent forms with your clinic’s provider information to minimize claim rejection rates.
  • Bulk Submission: Enable automated batching for daily insurance claims to speed up the reconciliation process.

4. How to Configure​

  1. Navigate to Settings > Financial Settings.
  2. Setup Billing: Configure your fee schedules and default payment terms.
  3. Configure Taxes: Define your tax rates and map them to the relevant service categories.
  4. Link Insurance: Add your insurance payers and customize the claim submission fields to match your workflow.
  5. Save & Validate: Click "Save" and run a "Trial Claim" to ensure your setup is processing correctly.

5. Frequently Asked Questions​

  • Can I have different prices for different insurance plans? Yes, the "Fee Schedules" feature allows you to create contract-specific pricing that automatically applies when a patient selects their insurance provider at check-in.
  • How do I handle rejected claims? The system provides an "Insurance Dashboard" that identifies rejected claims, explains the denial reason, and allows you to edit and resubmit the claim directly.