metaSOFT International
Financial & Operations Module

Patient & Physician Billing

metaSOFT Billing captures charges automatically from every HMS clinical module — OPD, IPD, ED, pharmacy, lab, radiology and OR — and generates insurance and self-pay invoices with the correct patient-insurance split calculated from pre-verified eligibility. Physician revenue is tracked separately by CPT and payer, with ZATCA e-invoicing compliance built in for Saudi facilities.

Automatic
Charge capture
Insurance
& self-pay
Full
Revenue cycle
Benefits

What your billing team gains on day one.

Automatic charge capture

Every service, procedure, medication and consumable used in any HMS module posts to the patient's invoice automatically; no manual re-entry by billing staff, no missed charges.

Insurance-self-pay split at the cashier

The co-pay, deductible and insurance liability are calculated from the pre-verified eligibility record before the patient reaches the cashier; billing staff do not recalculate manually.

Physician billing module

Physician fees are tracked separately by CPT code and payer; physician revenue reports by patient, specialty and insurance company are available in real time.

Revenue cycle dashboard

Outstanding AR by payer, denial rate, days-in-AR and collection efficiency are visible without requesting a report from the finance department.

Payment posting and EOB reconciliation

Insurance explanation of benefit files are posted against outstanding claims; unmatched payments and short-paid claims are flagged automatically; AR aging is updated in real time.

ZATCA-compliant e-invoicing

Saudi ZATCA Phase 1 and Phase 2 e-invoicing is built into the billing module; cryptographic signing and FATOORAH portal submission are fully automated.

Feature highlights

Every step of the revenue cycle, covered.

Automatic charge capture

  • Real-time posting from OPD, IPD, ED, pharmacy, lab, radiology and OR
  • Charge master with CPT, service codes and ICD-10 linkage
  • Manual charge entry for miscellaneous and non-clinical services
  • Charge audit report to identify missed-charge patterns

Patient invoice generation

  • Invoice generation at discharge or at visit completion
  • Co-pay, deductible and insurance split calculation from eligibility record
  • Invoice edit and adjustment workflow with approval and audit log
  • Multi-currency invoice for international private patients

Insurance claim management

  • Claim generation in NPHIES, EDI and paper formats
  • Prior authorisation reference linkage to claim
  • Claim submission and status tracking per payer
  • Denial management workflow and resubmission tracking

Physician billing

  • Physician fee schedule by service and payer
  • Physician revenue report by CPT code and payer
  • Consultant split billing for multi-physician encounters
  • Physician payment statement and bank transfer advice

Payment & AR management

  • Payment posting for cash, card, bank transfer and insurance EOB
  • Refund workflow with financial controller approval
  • AR aging report by payer, collector and age bracket
  • Automated dunning letter for overdue self-pay accounts

Revenue analytics

  • Gross vs. net revenue by service line and payer
  • Denial rate by payer, reason code and department
  • Days-in-AR trend by payer category
  • Charge capture completeness audit report
Part of metaSOFT ERP

Billing is the revenue recognition layer that sits between HMS clinical activity and the General Ledger.

Billing is the revenue recognition layer that sits between HMS clinical activity and the General Ledger. Every clinical event in HMS — an outpatient consultation, an inpatient bed-day, a pharmacy dispense, a CT scan — generates a charge that posts to the billing module in real time. Billing staff review, adjust where needed, and approve the invoice. The AR entry posts to the GL simultaneously with invoice generation; no manual journal entry is required.

For Saudi facilities, ZATCA Phase 2 clearance is built directly into the invoicing workflow. When a billing supervisor approves an invoice, the system signs it cryptographically, submits it to the FATOORAH clearance portal and stores the clearance UUID against the invoice record — without any manual step by billing staff. The 6-year ZATCA archive is managed by the Document & Imaging System module, with retrieval available in under 60 seconds for any audit request.