Glossary:

Account receivable : JLN term JLN Process - Accounts receivable

Account payable: JLN term Accounts payable 

outbound invoice, aka invoice: invoice that openIMIS send to some other third parties

inbound invoice, aka bill: invoice that openIMIS recieves from some other third parties

outbound payment, aka bill payment: payment that openIMIS send to some other third parties Payment to providers

inbound payment aka invoice payment: payment that openIMIS recieves from some other third parties like Premium collection and Funding

Models

See invoice model

change from invoice models

Subject type : Batch run (claim, contribution, fees) / claim / (out of scope) Right/ (out of scope) funding contribution /

third party type: HF, User, Payer(I don’t know where the document the payment platforms/ re-insurance), Insuree

Integration points:

Services

o billPaymentSent

o billPaymentRejected

o billPaymentRefunded

o billCreate (called on save)

o billUpdate (called on save)

o billDelete

o billItemCreate

o billItemUpdate

o billItemDelete

o billAmend

o billValidateItems

o billMatchItems

bill Payment specific modules (Calculation rules)

those calculation rules modules structure

• models: none

• services: 1 per signal listened

• static values

  • type: operation fee, supplier payment, reimbursment

• converters: one converter from another openIMIS object to invoice

• parameters: on for the “recipient” and “subject“ on the invoice

  • change might be required in the calculation module to save it in dedicated fields instead of json_ext OR we move those in the json ext fields

  • support search on those parameters

Listening to other modules signal are strikethrough because during the migration not all update will happens through modular therefore such trigger will complexity the invoice creation processes

[OUT OF SCOPE]Insuree cash transfet

converter

1. one accountPayable per insuree (for all dependant), one line per cash payment (level of Item and service)

2. one accountPayable per period, one line per cash payment claim

[out of scope]new signals are use to trigger action in another module:

o [one signal per service]

o billValidated (all billItemMatched and billItemAmountValidated)

o billFullyPaid

Create a FHIR interface for the accounting systems

Here the FHIR ressource to be used:

https://www.hl7.org/fhir/invoice.html

Acceptance criteria

1. Insurance clerk generates claim bill per health facility for a given time period

2. Insurance clerk generates commission bill per EO for a given time period

3. Insurance clerk generates capitation bill per HF for a given time period

4. Insurance clerk display the bill with details

5. Insurance clerk add a payment on the bill

6. Insurance clerk print the bill

7. Insurance clerk delete a bill (this won’t delete the generating Item)

Permissions

Invoice (also for invoice Item) Prefix will be 1561

• Search → 156101

• Create → 156102

• Update → 156103

• Delete → 156104

• Amend (create amendment) → 156109

Invoice Payment prefix will be 1562

• Search → 156201

• Create → 156202

• Update → 156203

• Delete → 156204

• Refund→ 156206

Invoice event Prefix will be 1563

• Search → 156301

• Create → 156302 (out of scope)

• Update → 156303(out of scope)

• Delete → 156304(out of scope)

• CreateMessage → 156306

• DeleteMyMessage → 156307

• DeleteAllMessage → 156308

Front end

See invoice page

nice to have: Third party renamed as Sender

• Either drop down as current screen

  • General Account Payable section

    • Select “Account payable”

    • Payment plan picker in the future data model

      • can be a static drop down list for the old model: Valuation / Capitation / Commission fees / payment fees + Product picker

      • Or calculation for payment plan using the product configuration could be created, then payment plan could be created for each products

    • two datetime entries: DateFrom/DateTo

    • Location picker

  • Export Account Payable section

    • Payment plan picker in the future data model

      • can be a static drop down list for the old model: Valuation / Capitation / Commission fees / payment fees + Product picker

      • Or calculation for payment plan using the product configuration could be created, then payment plan could be created for each products

    • two datetime entries: DateFrom/DateTo

    • Location picker

    • group by: Product or third party

    • third party: user(EnrolmentOffice)/HF/”insuree”

  • section “payment plan calculated” that will display all “Account Payable generated” with there input detail in 1 column, working var in a second and the result in the third (relative index)