Private hospitals
Mixed billing
Mixed billing organises the documents and financial components of a service that may involve CAS, a private insurer and the patient. Jovimed supports finance and patient-relations teams in examining amounts and differences under the applicable contractual rules.
Configuration, integrations and availability are discussed in your demonstration.
FOR
Finance teams · Patient relations · Contract owners
CONTEXT FOR THE TEAM
Contractual records of financial components
Organise records and responsibilities for applicable requirements; competent staff review documents and decisions.
Content reviewed on .
WORKFLOW PREVIEW
Illustrative workflow stages
Conceptual preview · Illustrative data
STAGE 1
Components are distinct
Staff identify payers and available documents before examining the estimate.
- Status
- Working estimate
- Data
- Illustrative
STAGE 2
The change has context
Documented services and conditions are examined before amounts are updated.
- Status
- Under review
- Data
- Illustrative
STAGE 3
Differences have an owner
Received information is compared with the record and observations remain followed.
- Status
- Clarification documented
- Data
- Illustrative
CAPABILITIES
What the team can follow.
A pre-service estimate and a final account serve different purposes. Staff need to explain each amount, its supporting document and who examined it. Configuration starts with actual contracts and available data rather than assuming that every service is covered.
Separate components
Distinguish the contribution followed for each payer and retain its documentary basis. A proposed value remains separate from a confirmed amount so staff do not confuse an estimate with reimbursement that has been completed.
Contractual rules
Associate a financial component with the documents and rules examined by its owner. Contracts and individual conditions are reviewed before calculation; a configured rule alone does not establish service eligibility.
Explainable estimate
Prepare a view of proposed amounts and information requiring clarification. Staff can examine the estimate with the patient using the documents and conditions available at the time of discussion.
Documented changes
Follow changes between proposed and documented services. Observations, versions and approval remain associated, while the owner examines financial implications before finalisation.
Differences for review
Connect requested amounts, received information and observed differences. Staff can assign a clarification owner and retain the response without considering an amount collected simply because it was requested.
Financial dossier
Connect the relevant documents for a reviewed case within established access boundaries. Finance staff see information necessary for their purpose; access to clinical documentation is not implicit.
IN PRACTICE
The final account differs from the estimate.
A planned service has several financial components. After activity is documented, staff find that a contractual document requires clarification before final amounts are determined. The initial estimate stays identifiable while the change receives explanation and review.
The owner compares the documented service with the estimate and identifies changed information.
Contract staff examine the rule and relevant documents for each component.
The difference and revised version are explained and approved in the facility’s workflow.
A view of amounts and supporting documents, with estimates separate from subsequent confirmations and collections.
RECORDS & TRACEABILITY
Records for review.
Financial records need to explain what an amount represents and when it was examined. The hospital defines documents, access rights and approval steps for its configuration.
- Estimates, components and documentary sources
- Contractual rules and examined versions
- Observations, differences and responses
- Approvals and recorded financial states
BEFORE YOUR DEMONSTRATION
Useful questions.
Does the platform confirm insurer coverage?
No. Conditions and confirmations belong to the insurer and contractual relationship. Jovimed can organise information and documents for review while distinguishing estimated, requested and confirmed amounts. Competent staff examine the applicable rule and discuss clarification before determining the final financial version used by the facility.
How are cost changes followed?
A change can be associated with the documented service, reason and estimate version. The owner examines documents for each component and records approval in the facility’s workflow. The initial estimate stays distinct from the final account; software does not decide whether an expense is covered by a contract.
Can finance staff see all clinical information?
Access is defined with the hospital according to role and purpose. A financial component does not implicitly provide access to the full medical record. The demonstration establishes required documents, their reviewers and visibility boundaries so the dossier can be examined without unnecessarily extending access to sensitive information.
START WITH A CLEARER PERSPECTIVE
Let’s talk about
your hospital.
Discover how registries, traceability and resource management fit into the way your team works.