Billing & Charge Capture
Build the bill from the care recorded
NextHealth Care
NextHealth Care
Included in all three Care plans; insurance claim processing is separately licensed.
NXH Care billing connects each charge to the activity that created it. When a consultation is signed, a draft bill opens and charges are composed from the consultation, procedures, laboratory, radiology and dispensed medication, priced from the service catalogue or the payer’s tariff. The total is divided between insurer and patient, and every line shows its source. Discounts, refunds and adjustments are limited to permitted roles and leave an audit trail, so the team can see how a bill reached its final amount.
Follow a charge from the care recorded to the final bill
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Step 1
Compose charges
Open the draft from the signed visit
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Step 2
Check lines
See each line’s source and price
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Step 3
Split the bill
Divide the total between insurer and patient
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Step 4
Finalise
Lock the lines, then record payments
What your team can do
- Open a draft bill when the consultation is signed.
- Compose charges from procedures, laboratory, radiology and dispensed medication.
- Price each line from the service catalogue, or from the payer’s tariff or agreement.
- Flag lines with no price for review before the bill is finalised.
- Divide the total between insurer and patient, with a note on the coverage rules applied.
- Limit discounts, refunds and write-offs to permitted roles, with an audit trail.
Trace each charge back to the care that raised it
A bill draws on work recorded by several teams, so an unexplained line usually sends someone searching other records. In NXH Care each composed line is labelled with its source, such as consultation, procedure, laboratory, radiology or pharmacy, and shows how its price was set where a payer tariff or agreement applies. A line with no price is flagged for review, and the bill cannot be finalised until the biller has acknowledged it.
Who can change a bill
A discount can be applied only while the bill is a draft and cannot exceed its subtotal. A refund needs its own permission and a recorded reason. These controls rest on roles and an audit trail. Care does not route discounts or refunds through a separate approval queue, so agree which roles hold those permissions before go-live.
Insurer and patient responsibility
The split follows the patient’s insurance plan: the share the insurer covers and the share the patient owes, with coverage notes recording rules such as copays and excluded items. A visit can be marked with a corporate or government payer type, but Care does not calculate a separate employer share. If your facility bills employers directly, bring that arrangement to the demonstration so it can be assessed.
Illustrative example: a signed visit becomes a split bill
This example uses synthetic data.
A doctor signs the consultation for a synthetic patient, Amira Sample, who also had one blood test. Care opens a draft bill with a consultation line and a laboratory line, each labelled with its source. Her plan carries a 20 percent copay, so Care divides the total into an insurer share and a patient share and adds a coverage note naming the rule applied. The biller reviews the lines, finalises the bill, and the cashier records the patient’s payment. A receipt can be produced as a PDF from the payment.
Billing is part of every Care plan. Submitting the insurer’s share as a claim belongs to Claims and approvals, which is included in Care Clinics Pro and Care Hospitals.
Related NXH Care modules
3 more modules
Common questions
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Billing is included in Care Clinics, Care Clinics Pro and Care Hospitals. The module is part of the shared clinical foundation in every Care plan.
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Care composes charges from the signed consultation, procedures, laboratory and radiology orders and dispensed medication, and from room nights for admitted patients. The service module that records the activity must be in your plan or add-ons for its charges to appear.
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Care divides a bill between the insurer and the patient using the patient’s plan, including copay, deductible and coverage rules, and records a note explaining the rules applied. A separate employer share is not calculated. If you bill employers or corporate clients, bring that arrangement to the demonstration.
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Insurance claims and approvals are included in Care Clinics Pro and Care Hospitals. Billing is in every Care plan, but it does not make the full claims workflow part of Care Clinics.
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A discount can be applied only while a bill is a draft and cannot exceed the bill subtotal. A refund needs a separate permission and a recorded reason. Both are audited. Care does not send them to a separate approval queue, so decide which roles hold these permissions before go-live.
Not answered here? Contact the team
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