Every invoice priced by your own contracts, as it’s made
Your contracts, tariffs and coverage rules work out each line at the desk — the patient’s share, the company’s share, and what needs the insurer’s approval first. Then the cashier closes the shift against counted cash, and billing sends each insurer its statement.
Contracting
Your insurance contracts, set up once
Contracting holds the whole model the desk bills by. Prices change over time: each contract runs in periods, and each period has its own tariff and dates.
Customer groups
Payers grouped as Credit, Cash or Cash Discount, with their customers, classes such as Gold, and policy numbers.
Tariffs
Price lists in tabs by speciality: the standard price, discount and net, the patient’s share, and each item’s coverage — Covered, Requires pre-approval or Uncovered — applied in bulk when you need to.
Contracts and periods
A credit contract sets the patient’s share as a percentage with a maximum, eligibility days and allowed visits, a share per speciality, and whether a service can be billed without a consultation.
Patient cards
Each patient’s insurance cards, with the contract, the card number and its validity. An expired card is refused at billing.
Episodes
A consultation or a package opens an episode with its validity and allowed visits. Follow-ups continue it, and it decides what’s a follow-up and what’s a new consultation.
Cash and cash discount
For patients who pay themselves: cash, or a cash-discount contract for every patient or only the ones you assign.
New invoice
A guided invoice, step by step
New invoice needs an open shift. A panel beside the steps lists what’s left before it can be submitted.
- 1
Patient
Outstanding and credit-balance chips, with Settle, before anything else
- 2
Clinic & doctor
The doctor’s clinic — or an open episode to continue
- 3
Billing contract
The contract to bill under; expired contracts and cards are refused
- 4
Services & items
Each line’s coverage, package balances, and the items the doctor ordered
- 5
Pre-approval codes
The insurer’s codes for the items that needed approval
- 6
Payment
Split across methods, pay later, or from the patient’s credit balance — allocated in full
- Doctors’ orders wait in the Front Desk’s Pending requests, and Create invoice preloads them.
- Sell a package once; later visits draw on it, showing how many are left.
Pre-approvals
Pre-approvals followed to the insurer’s answer
When a line needs the insurer’s approval, its request waits at the front desk under Needs a reply until the approval letter is recorded — item by item, with what was approved.
- Needs a reply and Answered: each request with its items, the quantity requested and approved, and the amount covered.
- Add approval letter: the document number, dates, attachments, a reply per item, the approved quantity and a revised amount.
- Pre-approval responses on the Front Desk — Approved, Rejected or Needs more details — and how many are still waiting.
- An item the insurer rejected can’t be billed under the contract, and the invoice says why.
- A patient’s approval letters over any period, with their validity and attachments.
After the invoice
Refunds, balances and what’s still owed
Find invoice
Search by contract type, customer, sale or refund. Each invoice shows its items, the payments per method, “Paid in full” or what’s outstanding, and its refund trail.
Refunds with approval
Pick the items and quantities, a reason and a method. The request is reviewed — requested, then approved or rejected — and paid out from an open shift.
Patient balances
Add to a patient’s credit balance, refund it, and see its history.
Unpaid invoices
Settle a patient’s unpaid charges as a checklist, in part if needed, with one Collect.
Shifts
Every shift closes against counted cash
A shift opens with its float, and invoicing, settling, top-ups and refunds all need one open. At the end the cashier counts each payment method against what the system expects, and hands the shift to the person who receives it.
- Count & close, method by method: expected against counted, with a reason for any difference.
- Open, then Awaiting handover, then Received — by someone else.
- The shift’s transactions as a timeline, with its summary figures.
- A shift report as a PDF.
- A shift closed from another screen reaches the cashier’s at once.
Statements
Statements to each insurer, by period
Pick a customer and a period, tick the episodes, and create the statement. The statement, its list and its episodes’ invoices print as PDFs, and the home dashboard shows what the insurers still hold.
New statement
A customer, a period, and the episodes to include.
Approve medically
The first approval of what’s in it.
Approve financially
The second approval, of the amounts.
Dispatch
Marked as sent to the insurer. A statement can be reverted if it needs to change.
Questions
Before you ask
Not yet for a single invoice at the desk. Statements print as PDFs with their list and their episodes’ invoices, and so do shift reports.
Not yet. Pre-approvals and statements are prepared in ClinicWorks and sent by you; there’s no connection to insurer portals, NPHIES, ZATCA e-invoicing or accounting software.
Each contract runs in periods, each with its own tariff and dates, so a new price list starts on its date while the periods before keep theirs.
Yes. Cash and cash-discount contracts cover patients who pay themselves, with split payments, pay later, packages and credit balances. Insurance is there when you need it.
So every payment and refund belongs to a cashier’s shift, and the shift can close against counted cash. Invoicing, settling, top-ups and refunds all need one open.
Your organisation’s own, set from its country when it’s set up. Papers print amounts without a currency symbol.
See ClinicWorks against your own clinic day
Try it free for 14 days and set your clinic up yourself, or book a walkthrough on a call, shaped around how your clinic runs today — your bookings, your contracts, your doctors.
Try the live demoComing soon