Medical365 hospital billing software manages OPD/IPD invoicing, GST compliance, insurance TPA pre-authorization & multi-mode payments for Indian hospitals.
Billing and invoicing software is an enterprise-grade hospital financial ERP and revenue cycle management (RCM) module. It automates outpatient and inpatient billing, applies tariff structures across general and private ward tiers, processes cashless insurance TPA pre-authorizations and government schemes (PMJAY), ensures GST compliance, and reconciles multi-mode payments.
Addressing high-volume OPD congestion, diagnostic fragmentation, and statutory healthcare regulations.
Financial management in a hospital is complex. Unlike retail businesses, hospital billing involves hundreds of interdependent clinical micro-transactions: doctor consultation fees, diagnostic investigations, nursing charges, bed tariffs, operating theater minute rates, surgical consumables, pharmacy items, and anesthesia fees.
In conventional Indian hospitals, billing is fragmented and prone to severe revenue leakage. Disconnected departmental billing leads to missed charges for inpatient consumables, delays in compiling discharge bills (often forcing patients to wait 4-6 hours on discharge day), and manual calculation errors. Crucially, managing private insurance TPAs (Third Party Administrators) and government cashless schemes using manual paperwork leads to frequent claim deductions, disputed pre-authorizations, and delayed hospital reimbursements.
Medical365's Hospital Billing module integrates clinical care directly with financial accounting. As doctors order tests, nurses administer drugs, and surgeons execute procedures, charges flow automatically to the patient's digital folio. With 1-click insurance claim package compilation, dynamic UPI payment QR codes, and automated discharge bill generation, Medical365 eliminates revenue leakage and accelerates cash flow.
Engineered with medical sub-specialists to eliminate manual charting friction and enforce clinical protocol rigor.
Seamlessly manages outpatient consultation billing, diagnostic test invoicing, day-care procedure packages, and multi-day inpatient hospital stays on a unified ledger.
Automates differential pricing based on bed category: General Ward, Semi-Private, Deluxe Private, and ICU rates with customized doctor visit fee structures.
Manages end-to-end insurance workflows: initial pre-authorization request, query response, interim enhancement requests, and final discharge claim packages with attached bills and discharge summaries.
Pre-configured package rates and billing rules for Ayushman Bharat PMJAY, CGHS, ECHS, and state welfare schemes with automated pre-auth documentation.
Enforces Indian GST rules, segregating tax-exempt healthcare services (SAC 999312) from taxable pharmacy retail products, aesthetic procedures, and luxury private room categories.
Integrated dynamic UPI QR codes on billing screens, POS card swipe terminals, and automated payment links sent to family members for advance inpatient deposits.
High-resolution data flow architecture connecting point-of-care capture, diagnostic instruments, and national health registries.
A transparent 5-stage digital pathway standardizing patient care from initial requisition to longitudinal review.
Doctor orders, nursing administrations, and OT charges stream automatically into patient billing folio.
TPA desk submits electronic pre-authorization request with estimated cost; initial approval letter attaches to bill.
Family deposits advances via UPI QR code at admission; digital receipt issues instantly to WhatsApp.
Final discharge bill compiles in under 3 minutes with itemized pharmacy, bed charges, and doctor visits.
Co-pay collected; TPA final approval confirms; system issues digital Gate Pass releasing patient.
Medical365 Hospital Billing complies with Indian Goods and Services Tax (GST) healthcare regulations, Insurance Regulatory and Development Authority of India (IRDAI) claim guidelines, and National Health Authority (NHA) PMJAY standards.
All financial transactions, invoice ledgers, and insurance claims are encrypted under AES-256 compliant with the DPDP Act 2023.
See how automated digital intelligence transforms efficiency, reduces diagnostic turnaround times, and protects clinical revenue.
| Feature / Requirement | Conventional Manual Practice | Medical365 EMR Solution ★ |
|---|---|---|
| Discharge Billing Speed |
✕ Manual Method: Manual compilation taking 4-6 hours on discharge day; angry families |
✓ Medical365 Solution: Instant automated compilation completed in under 3 minutes |
| Revenue Leakage |
✕ Manual Method: Ward consumables, extra dressings, and night doctor visits forgotten |
✓ Medical365 Solution: Zero leakage; all nursing administrations and doctor visits auto-post to folio |
| Insurance Claim Processing |
✕ Manual Method: Paper claim folders with photocopies mailed to TPAs; high rejection |
✓ Medical365 Solution: Digital claim packages with attached EMR notes, lab reports, and itemized bills |
| Payment Convenience |
✕ Manual Method: Long queues at single cash counter; disputes over change |
✓ Medical365 Solution: Dynamic UPI QR codes, debit/credit POS, and payment links on WhatsApp |
| Financial Audit Readiness |
✕ Manual Method: Disorganized paper ledgers and manual tallying prone to fraud |
✓ Medical365 Solution: 100% audit-proof digital ledger with real-time cashier shift reconciliations |
Seamless bidirectional data sharing across all hospital clinical departments and diagnostics.
Clinical, technical, and regulatory answers for hospital directors and medical specialists.
In conventional hospitals, discharge billing takes hours because staff must collect physical chits from pharmacy, labs, and wards. With Medical365, all clinical charges post in real time to the digital folio. The moment the doctor signs the discharge summary, the final itemized bill is ready instantly.
The insurance module compiles complete digital claim packages: it attaches the diagnosis code, itemized billing summary, diagnostic reports, and medical justification notes, reducing TPA query turnaround times.
Yes. The software supports automated tariff tiers: doctor consultation fees, nursing charges, and room tariffs can scale automatically based on the patient's selected room category (General, Semi-Private, Deluxe, ICU).
When an invoice is generated, the cashier screen displays a dynamic UPI QR code encoded with the exact outstanding bill amount. Patients scan with Google Pay, PhonePe, or Paytm; payment confirms instantly without manual verification.
Yes. Medical365 includes pre-loaded PMJAY specialty packages, pre-authorization workflows, and mandatory clinical documentation checklists required for state health scheme reimbursement.
Yes. Daily sales ledgers, receipt summaries, tax breakdowns, and doctor revenue-share data can be exported directly to Excel, CSV, or synced with Tally ERP.
