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Concept explainer

A worked admission in rupees

Walks through one admission and the charges it generates in rupees, showing how each posting reaches the bill and the final total.

This page walks through one admission and the charges it generates in rupees, showing how each posting reaches the bill and the final total. It follows a single inpatient stay at a notional hospital, from the first order to the settled account, so the finance head can see where every figure comes from.

The admission

A patient is admitted for a planned procedure and stays three nights. Gate opens the admission and takes a deposit of INR 10,000 at the front desk. Over the stay a clinician places orders in Forge, and each chargeable order hands a charge to Vault.

A charge is the billable consequence of one event, such as a night in a bed or a dose dispensed. Vault raises a charge the moment the order behind it is placed, and the charge carries the price in force on that service date.

Each posting in order

The stay generates seven postings. Each one is raised by the order that sits behind it and carries the price that applied when the service was given.

PostingOrder behind itAmount
Room charge, three nightsBed occupancy, per nightINR 12,000
Specialist consultation, twoConsultation orderINR 1,600
Blood panelInvestigation orderINR 1,200
Chest X-rayImaging orderINR 600
Minor procedureProcedure orderINR 8,500
Medication dispensedMedication orderINR 2,340
ConsumablesProcedure consumablesINR 1,160

Medication is charged per dispense, per strip or vial issued, so the pharmacy posting reflects what left the store rather than a count of doses. Every other posting reflects the service the order named.

Each posting carries its own price

A charge captures the tariff in force on its service date. A later change to a rate leaves the charge as it stood, so a posting read months afterwards still shows the price the patient met at the time.

From posting to bill

At discharge, Vault assembles the postings into one invoice. Tax applies by item type: the clinical services here sit outside tax, and the pharmacy and consumable lines carry GST. The deposit taken at admission is adjusted against the total, and the remainder is the balance the patient settles.

LineAmount
Charges subtotalINR 27,400
Tax on taxable itemsINR 420
Invoice totalINR 27,820
Deposit adjustedINR 10,000
Balance to settleINR 17,820

The subtotal is the sum of the seven postings. Tax of INR 420 falls on the medication and consumable lines. The deposit of INR 10,000 comes off the invoice total of INR 27,820, leaving a balance of INR 17,820 for the patient to clear before the account closes.

Figure 1.Diagram showing one admission moving from open admission through orders and charges to an invoice and settlement.

When a charge becomes real

A charge becomes real when the order behind it is placed. From that moment it sits on the account as an amount owed by the responsible party, and it stands there before any invoice is cut. A room charge accrues each night of the stay while the single discharge invoice is still days away.

When a charge becomes fixed

A charge becomes fixed when it lands on a finalised invoice. After that, a correction is a fresh entry rather than an edit: Vault raises a credit note that reverses the charge and preserves the invoice number. This keeps the financial history complete and reconstructable. Read how a charge stays fixed.

When a payer shares the cost

The walkthrough above is self-pay. When an insurer or scheme covers part of the stay, the same postings split into a payer-covered share and a patient-responsible share. The patient settles their share at the counter, and Vault carries the covered share into a claim to the payer. The postings and their prices stay the same; only the split changes.

Common questions

Why does the room charge appear before the invoice exists?

A charge sits on the account as soon as its order is placed. The invoice is assembled later, at discharge, from the charges that accrued through the stay.

How is a charge corrected once it is on the invoice?

Vault raises a credit note against the finalised invoice. The original charge and invoice number stay in place, and the credit note carries the correction as its own entry.

Where does the tax figure come from?

Tax applies by item type. The pharmacy and consumable lines carry GST, and the clinical services on this stay sit outside it. Read the detail in tax and statutory charges.

Follow the same postings through their pricing steps in the pricing waterfall.