Billing & Revenue Cycle
Manage medical aid claims, cash payments, GEMS tariff codes, invoicing, and revenue tracking.
Billing Dashboard
The Billing page provides a comprehensive view of all requests with billing information. Each row displays:
| Column | Description |
|---|---|
| Patient | Patient name |
| Test | Test description (tariff code text, LOINC description, or free text) |
| Status | Request status: Ordered, In Progress, Completed, Cancelled |
| Priority | Routine or Urgent |
| Medical Aid | Medical aid name and membership number (if applicable) |
| Payment | Cash or Medical Aid indicator |
| Created By | Staff member who created the request |
| Service Date | Date of specimen collection with creation timestamp |
Use the search bar to filter by patient name and the status dropdown to filter by request status.
Payment Types
Medical Aid
When a patient has medical aid registered on their profile, claims are automatically linked to their medical aid. The following details are attached to each claim:
- Medical aid scheme name (e.g. Discovery Health, Bonitas, GEMS)
- Plan / option (e.g. KeyCare Plus, BonComprehensive)
- Membership number
- Main member name (if different from the patient)
Cash Payments
For patients without medical aid, mark them as a cash patient during registration. On the request, select the payment method:
| Method | Description |
|---|---|
| Cash | Physical cash payment at the collection site |
| Card | Debit or credit card payment |
| EFT | Electronic funds transfer / bank payment |
Enter the amount paid and optionally assign an invoice number and receipt number for reconciliation.
GEMS Tariff Codes
Every test in Path.systems maps to a Government Employees Medical Scheme (GEMS) tariff code. These are the standard billing codes used across South African medical aids for pathology services.
Automatic Assignment
Common Tariff Codes
| Code | Test | Category |
|---|---|---|
| 3755 | Full Blood Count | Haematology |
| 3743 | ESR / Viscosity | Haematology |
| 3805 | PI / INR | Haematology |
| 4171 | U & E, Creatinine | Chemistry |
| 4057 | Glucose (Fasting/Random) | CHO Metabolism |
| 4064 | HbA1C | CHO Metabolism |
| 4091 | Lipogram Full | Fat Metabolism |
| 4131 | Liver Function Tests | Liver |
| 4484 | Thyroid Profile / TSH | Thyroid |
| 4448 | B-HCG Screen | Pregnancy |
| 4531 | Hepatitis Panel | Virology |
| 3932 | Ante Natal Screen | Ante Natal |
Invoicing & Reconciliation
Each request can be assigned:
- Invoice Number — your internal invoice reference for the claim or cash payment
- Receipt Number — proof of payment reference, especially for cash transactions
- Account Number— the patient's system-generated account number (e.g.
MAN1SG5) for cross-referencing
Individual test items within a request each track their own payment status, so you can see which tests have been paid and which are outstanding.
Export & Integration
Billing data can be exported for use with external billing software. See the Billing Software Integration guide for details on file formats, field mappings, and automated export configuration.