Hospitals & Healthcare

A hospital does not sell goods

It sells services — a consultation, a blood test, an X-ray, a night in a room, a surgery — and many of those consume drugs and supplies from a warehouse at the same moment. And the patient usually does not pay alone. Nama’s hospital module is built on those two facts rather than bolted onto a trading system:

• Every service carries a price and a cost. The price is charged; the cost may be shared with the doctor or another party.
• Every invoice line splits automatically into the patient’s share and the insurer’s share, from the endurance percentages on the approval and the admission.
• An admission carries the insurer’s cap — the maximum they will cover across all invoices — with a live remaining figure, so the ceiling is visible before it is breached rather than after the claim is cut.

One journey, from the door to the closing invoice

A patient is registered once, and that file is both a medical record and an accounting party. An outpatient is booked into a slot on a clinic schedule. A patient being admitted gets a patient admission, and everything afterwards branches from it.

From the admission, an accommodation document assigns a bed and starts the daily room and medical-supervision charges. Transfers between rooms are documents. Meals are issued. The doctor orders lab tests, radiology and surgeries, results are recorded against those orders, and the pharmacy dispenses against the same patient.

Each service produces its own invoice, split between patient and insurer as it goes. At discharge an exit document frees the bed, and a single closing invoice gathers every invoice raised under that admission into one final statement.

Orders and results, as one pattern

The clinical side is deliberately repetitive, which is what makes it learnable: a request raised by the doctor, then a result entered by the department, linked to each other and priced on the way through.

Lab results are where the design shows. Choosing the test type loads its components and fills in the normal range appropriate to that patient’s demographic — male or female, adult or child — so the technician enters the measured value and nothing else. The lookups filter themselves: test types that match the request, and requests not yet resulted.

Insurance is the hard part, so it is the configured part

An insurance company is a full accounting party, with its coverage liability posted and aged like any receivable. Above it sit the classifiers — insurance class, company class, patient class — that decide which price applies to whom.

Price lists, cost lists, discounts and overheads all share one structure: a tab per service area — accommodation, consultation, attendants, lab, radiology, surgery, physiotherapy, pharmacy, supplies, supervision, services, blood bank — and lines matched at billing time on the service, the degree, the insurance and patient classes, the period and a priority to break ties. The same shape, twelve times, is why a hospital can actually maintain its own prices.

For operations billed as a bundle, a surgery package agrees a fixed all-in price: its lines map to the real service categories they cover, and the package invoice compares the agreed price with what was actually delivered and posts the difference. The underlying services are still recorded individually, which is what keeps cost and the doctor’s entitlement honest.

The pharmacy is the warehouse

Pharmacy, stores and blood bank are warehouses in the same inventory ledger the rest of the ERP uses, with batch and expiry tracking. A drug dispensed to a patient is one movement that reduces stock and charges the account — not a pharmacy transaction that someone reconciles against a stock system at month end.

Saved means posted

There is no separate posting step. A document is a draft while you are working on it, and the moment it is saved out of draft it creates its accounting effect — revenue, cost, the patient’s balance, the insurer’s balance — and may generate the documents that follow it, including the stock issue. The billing is a consequence of the treatment being recorded rather than a reconstruction of it afterwards.

Patients, admission and accommodation, clinical orders, insurance and approvals, pricing and the invoicing chain are documented in the hospital section.