Hospital Billing and EHR Systems: Pharma Operations

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Apply hospital billing software and EHR systems to manage administration and insurance workflows efficiently

By Suresh S. Verma

Last updated April 10, 2026

Current Status

Not Enrolled

Price

₹200,000.00

This program provides a comprehensive understanding of hospital administrative workflows with a focus on hospital billing software, billing software for hospital operations, electronic medical report systems, and EHR (Electronic Health Record). It covers the complete patient journey from registration to discharge, including admissions, insurance processing, billing, and records management. The program enables professionals to leverage digital tools like EHR and hospital billing software to improve operational efficiency, ensure accurate documentation, streamline insurance claims, and enhance patient service delivery in healthcare organizations.

Course Content

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Overview of Hospital Administrative Workflow

Patient administrative journey 9 Topics

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Patient Registration

Triage / OPD Consultation / Emergency Admission

Admission Process

Insurance / TPA Verification and Pre‑Authorization

Inpatient Care Coordination

Interim Billing and Documentation

Final Billing and Insurance Claim Processing

Discharge Planning

Post‑Discharge Insurance Settlement and Records Management

Patient Registration Process

Objectives 1 Topic

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Ensure accurate demographic and identification capture for legal, clinical, and billing purposes.

Patient Registration Process Steps 5 Topics

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Patient arrives at OPD / Emergency / IPD desk

Registration executive collects: Name, Age / Gender, Address, Mobile number and ID proof (Aadhar / PAN / Passport)

Unique Hospital Identification Number (UHID) generated

Patient category classification: Self‑pay, Insurance, Corporate and Government Scheme

Creation of Electronic Medical Record (EMR)

Responsible Staff 2 Topics

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Front office executive

Registration supervisor

Admission Process (IPD)

Admission Triggers 3 Topics

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Emergency admission

Planned admission

Doctor advised admission from OPD

Admission Steps 7 Topics

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Admission request by consultant

Bed availability check through Bed Management System

Admission form completion

Consent forms signed

Advance deposit collection (for self‑pay patients)

Insurance desk notified if insured

Patient file created and transferred to ward

Key Documents 4 Topics

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Admission consent

Financial consent

Treatment consent

Patient identification band

Responsible Staff 3 Topics

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Admission executive

Nursing supervisor

Duty medical officer

Insurance / TPA Process

Insurance Types 3 Topics

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Private insurance

Corporate insurance

Government schemes (e.g., Ayushman Bharat, State schemes)

Step 1: Insurance Verification 2 Topics

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Insurance desk verifies: – Policy validity – Sum insured – Coverage eligibility – Network hospital status

Documents required: – Insurance card – ID proof – Doctor admission notes

Step 2: Pre‑Authorization Process 2 Topics

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Documents submitted to TPA/Insurance: – Pre‑authorization request form – Doctor’s diagnosis – Investigation reports – Estimated treatment cost

Process: 1. Pre‑auth submitted via portal/email 2. Insurance company reviews request 3. Query raised if required 4. Pre‑authorization approval issued

Step 3: Enhancement Requests 1 Topic

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If treatment cost exceeds approval: – Revised estimate submitted – Additional reports attached – Enhancement approval obtained

Responsible Staff 3 Topics

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Insurance coordinator

TPA executive

Billing department

Inpatient Administrative Management

Clinical Documentation 3 Topics

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Doctor progress notes

Nursing notes

Investigation reports

Billing Updates 1 Topic

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Charges added for: – Room rent – Procedures – Medicines – Investigations – Consumables

Interim Billing 1 Topic

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Interim bills generated every 24–48 hours for: – Self‑pay monitoring – Insurance documentation

Coordination Units 4 Topics

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Billing Process

Components of Hospital Bill 8 Topics

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Room charges

Doctor consultation fees

Billing Controls 3 Topics

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Package billing for surgeries

Insurance tariff mapping

Corporate rate cards

Daily Billing Monitoring 1 Topic

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Billing department checks: – Missing charges – Duplicate entries – Package compliance

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Meet Your Instructor

Suresh S. Verma

1 Courses

0 Student

Mr. Suresh is a Hospital administration and operations expert with 14+ years of experience in the Healthcare and Hospital domain with exposure in Indian region. He is currently a Freelance Consultant and was previously the Head of Wellness at Jehangir Hospital. He completed his education at Indian Institute of Management Ahmedabad. His key skills include - Administration, Revenue Cycle, Healthcare Management, Operations.