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Chapter One: Design & Implementation of Hospital Billing and Payment System

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DESIGN & IMPLEMENTATION OF HOSPITAL BILLING AND PAYMENT SYSTEM

CASE STUDY BARAU DIKKO TEACHING HOSPITAL

CHAPTER ONE
INTRODUCTION

Background to the study

Healthcare establishments like hospitals, rehabilitation centers, health-saloons etc. are seen as

figures of hope by the sick and diseased. Just like other organizations, medical establishments

are also well-organized, following rigid and complex processes. These establishments require

efficient and strong manpower for proper management of their processes. Their main objective is

to offer quality healthcare to patients in a proper and cost-effective way. In recent years, there

has been noticed a rapid growth in the health sector in the country (Mathauer, 2015), which in

turn has created a need to build an application that will address most of the issues addressed in

this research work. This research work will be of paramount importance to the medical sector as

it will be designed to address most of the challenges that delay some of the administrative work.

Hospital billing and payment system is a web based system which focuses on achieving a

completely automated approach to generating patients’ bills and payment of those bills

respectively. The system is designed to register a patient and make use of the medical diagnosis

provided by the consultant to extract or formulate a bill containing all expenses and their

corresponding prices with a sum total of all the expenses. This information is used to pay the

bills via wireless transaction. The system also provides an interface for the administrator (i.e. the

medical doctor, consultant, nurse or any authorized personnel as the case may be) to manage
patients’ information and this is the medium through which the consultant gives his diagnosis

and prescription to the patients. This will help the hospital to keep track of all registered patients

in the hospital.

Health of the citizens is the wealth of a Nation. By using the cutting edge technologies, Hospital

Management can be improved with efficient work flow and communication. Details of the

Patients, their previous visits etc. are totally not perceptible without a computer. Relevant

Information is always stored in the computer and are available instantly in front of the

user“Gunter et al (2005)”.

Motivation for the study

The most important role of a computer scientist is being able to use acquired knowledge for the

betterment of the people around him and the society at large. This and many more reasons aided

in the drive for this project.

It has been observed that to receive medical treatment in most of our hospitals, the patients queue

up for several hours from one unit of the hospital to another starting from obtaining a new

hospital folder, or retrieving an old one before consulting a doctor, to the laboratory unit for lab

test then to the pharmacy to get the prescribed drugs and so on. With the manual processes

involved in handling the patient most of them waste the whole day in the hospital. Very often,

patients leave their homes very early in the morning in order to be among the first group to see

the doctor. Otherwise, they may end up wasting the whole day without due attention. This

situation is discouraging to most patients and sometimes forces them to turn to non-professionals

or even resort to self-medication for quick recovery.


Moreover, the volume of work for the hospital personnel is much. Patients outnumber the

doctors, nurses and other medical personnel that too much are required from them. In this

regard, to examine all his patients for the day the doctor hurries over his work without adequate

attention and expertise to his clients. Still, at the end of the day he is exhausted.

In addition to this, the diagnosis and prescription depend on the doctor’s memory and drug of

choice. Their brains are often loaded with different diseases, signs and symptoms, complications

and various drugs for their treatment and so on. Some of which are very similar. To remember

and process these huge information in his clinical work is very tasking. For this reason accurate

diagnosis and prescription may not always be obtained. The keeping and retrieval of accurate

records on patients are poorly carried out in most of our hospitals. Files may be misplaced; the

record in them may be wrongly filled. Hence, it is not easy to obtain accurate and timely

information or data. This is also the case with obtaining other medical information and data

especially when new folders and numbers are obtained each year.

Finally, the keeping of folder for each patient manually takes a lot of time and money and some

of the information are redundant. All these have net effect of loss of lives and inefficiency on

the part of management. Hence the reason for this project.

Problem Statement

For several decades, medical billing was done almost entirely on paper. However, with the

advent of medical practice management software, also known as health information systems, it

has become possible to efficiently manage large amounts of claims. Many software companies

have arisen to provide medical billing software to this particularly lucrative segment of the

market (Reese and Chrissy 2014).


Even though most hospital administrative work has been computerized, patients billing and

payment is still handled manually by receptionists and cashiers respectively which demands too

much time and effort to carry out especially with a very large number of patients trying to collect

and pay their bills at the same time.

This study examines the impact of information technology on health care system in Nigeria. An

electronic health record is a record in digital format that is capable of being shared across

different health care settings, by being embedded in network-connected enterprise-wide

information systems. Such records may include a whole range of data in comprehensive or

summary form, including demographics, medical history, medication and allergies,

immunization status, laboratory test results, radiology images, vital signs, personal stats like age

and weight, and billing information. Its purpose can be understood as a complete record of

patient encounters that allows the automation and streamlining of the workflow in health care

settings and increases safety through evidence-based decision support, quality management, and

outcomes reporting.

With many writers decrying how patients queue up for hours in order to receive medical

treatment, and some end-up being attended to as ‘spillover’, the analyst investigated the manual

system in detail with a view to finding out the need to automate the system.

Hospital billing and payment system easily automates the whole process of collating; retrieving

and gathering patient information and as a consequence it results in improved response time

towards the patient's demands. Doctors and other senior staff of the hospital would be capable of

spending their precious time in other clinical activities over simple clerical activities. Sometimes

it happens that accounting becomes very much complicated and pathetic. Using the software will

remove all such complexities as it helps you retrieve your information accurately.
Aim and objectives of the study

The project hospital billing and payment system” is aimed to design and implement a system that

eases the extra pain that patients have to endure in billing and payment exercises.

The objectives of this project are to:

a) Design a system that can register a patient into the hospital database and allows the patient to

generate a bill and make payment to the hospital online.

b) Build a structural database that stores medical information of all the patients registered.

c) Design an interface that allows an administrator access to all registered patients’ medical

records.

Scope and Limitation

This research work focuses on achieving a completely authomated approach to generating

patients bills and payment of those bills respectively.this information is used to pay the bills via

transaction the system also provide an interface for the administrator(i.e the medical doctor,

consultant, nurse or any authourize personnel as the case may be) to manage patients

information.

SIGNIFICANCE OF STUDY

The significance of study it to provide an useful information means to enable the management of

billing and automate their record keeping process for better updating and presentation on report

ORGANISATION OF THE RESEARCH


These research work is organized into five chapters. Chapter one is concerned with the

introduction of the research study and it present preliminaries, theoretical background,

motivation of study, problem statement, aim and objective of the study, significance of study,

organization of research.

Chapter two focuses on the literature review, diagnosis, billing, history of billing, the act of

medical billing.

Chapter three is concerned with the system requirement and specification, system analysis and

design, database design and structure. Usecase and activity diagram also discuss in this chapter.

Chapter four present system implementation and documentation. Features of implementations

language, system testing strategies, target system requirements.

Chapter five focuses on summary, conclusion and recommendation are provided on these chapter

based on study carried out.

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