Private insurance and corporate claims, and receivables aging

Patients with an insurance or corporate payer create payer receivables when the invoice is finalized. The Claims module groups these receivables into claims and tracks their payment.

Flow

1. The cashier finalizes the invoice; the payer portion becomes an insurance or corporate receivable.
2. Finance creates a claim per payer (per period or per visit) and prints or sends the claim documents.
3. Status: submitted → partially paid/paid → rejected.
4. When the funds are received: record the payment; any difference is recorded as a claim adjustment with a reason.

Receivables aging

The aging report shows receivable balances per payer (BPJS, insurance, corporate, patient) in age buckets, for example 0–30, 31–60, 61–90, and > 90 days. Click a balance to see the source invoices or claims.

Tips

• Follow up on receivables older than 60 days every week.
• The insurance claims module is included in Klinik Pro and Enterprise and is an add-on for the Klinik plan.