Finance

A real general ledger, not a billing afterthought.

Every dispense, lab test, consultation, and payment posts to a double-entry ledger inside the same transaction as the clinical event. Pricing is payer-aware and effective-dated. NHIS claims are a managed workflow. Each branch keeps its own books; the group rolls up — without a separate accounting package to reconcile against.

See the ledger in a demo

Books that can't drift from reality

Immutable double-entry journal

Every financial movement is a balanced journal entry — debits equal credits, enforced at the database. Entries are append-only: nothing is edited or deleted. Corrections happen the way accountants expect, through reversing entries that reference the original.

Ghana hospital chart of accounts

Ships with a standard chart of accounts tuned for Ghanaian hospitals — NHIS Receivable, NHIS Adjustment Expense, GRA categories. Each entity can add its own sub-accounts (Cash at GCB, Cash at GTCO) under the shared template.

Clinical events post automatically

A pharmacy dispense, lab test, consultation, or patient payment posts to the ledger inside the same database transaction as the clinical event. If the journal entry doesn't balance, the whole operation rolls back — the books can't drift from reality.

Patient AR sub-ledger

Patient balances live in a sub-ledger feeding a single GL control account. A nightly reconciliation job confirms the sum of patient balances still equals the control account — and alerts finance the moment it diverges.

Journal entry — Pharmacy dispense

JE-018342 · RX00142 · Accra HQ · posted 2026-05-21

Balanced

Account	Debit	Credit
1100 · Accounts Receivable — Patients	87.50	—
5100 · Cost of Goods Sold	41.20	—
4100 · Pharmacy Revenue	—	87.50
1300 · Inventory	—	41.20
Totals	128.70	128.70

Amounts in GHS. Posted by the dispense flow — no manual entry. A reversal is the only legal correction.

A pharmacy dispense posts a balanced journal entry — revenue and cost-of-goods legs together — inside the same transaction. Debits equal credits, or the dispense rolls back.

Pricing that knows who's paying

Configurable payer plans

Cash, NHIS, private insurance, corporate, staff, indigent — payer plans are data, not hard-coded enums. Each carries typed coverage, discount, and billing rules: coverage percentage, copay, per-visit caps, claim-filing windows.

Effective-dated price schedules

A price binds a service item to an entity, a payer plan, and a date range. A May price rise never rewrites a March invoice — invoices always reference the schedule row active on the service date, so history stays accurate on its own.

Layered drug pricing

Drug prices resolve through four layers in a locked order — branch override, payer-specific price (NHIS gazetted rates), manual list price, then category-markup fallback. First match wins. The same drug prices correctly for every payer at every branch.

Catalog approval workflow

Price changes are proposals, not direct edits. A lab manager or pharmacy head proposes; a finance officer reviews the batch with current-vs-proposed columns and a percentage delta, then approves or rejects. Proposer can never be their own approver.

NHIS claims, end to end

Claims as a managed workflow

An NHIS claim is built from an invoice and tracked through its full lifecycle — filed, acknowledged, adjudicated, settled. Not a checkbox on a bill: a first-class record with its own status and audit trail.

Batch remittance reconciliation

Import the NHIS remittance advice as a CSV with a per-payer column mapping. The system auto-matches lines to claims by reference and amount; whatever doesn't match drops into a reconciliation queue for manual matching.

Four partial-claim resolutions

When NHIS pays less than billed, finance resolves the gap one of four ways — rebill the patient, write it off, split it, or dispute it. Each resolution posts its own paired journal entry, so the books reflect exactly what happened.

Branch books, group rollup

Each branch keeps its own set of books and settles to its own bank account. A group HQ entity sits above them. Consolidated reporting is a query rollup across entities — no separate central ledger to keep in sync.

Close the books, see the whole group

Bank reconciliation

Each entity's bank accounts link to ledger Cash accounts. Upload a bank statement CSV, configure the column mapping once per bank, and match statement lines against journal lines. Unmatched items become a reconciliation queue.

Period close

Closing a period for an entity makes its posted entries read-only. Corrections after close require a reversing entry in an open period — the same discipline an external auditor expects, enforced by the system.

Per-entity reports

Trial balance for any date, P&L for a period, balance sheet as of a date, AR and AP aging, cash position, reconciliation status. Export to both PDF and Excel — the formats Ghanaian external accountants actually ask for.

Group-consolidated view

HQ-role users see a group P&L, cross-entity cash position, and a per-branch P&L ranking. Inter-branch transfers create paired offsetting entries that net to zero in consolidation — no double-counting across sites.

The finance most hospital systems leave to spreadsheets

	Capability	Typical hospital system
Double-entry general ledger	Separate accounting package	Included
Immutable entries, corrections via reversal	Not included	Included
Clinical events auto-post to the ledger	Not included	Same transaction
Effective-dated pricing	Price field overwritten	Included
Payer-aware price resolution	Not included	4-layer resolver
Price changes require approval	Not included	Propose → approve
NHIS remittance reconciliation	Manual	Included
Per-branch + group-consolidated P&L	Not included	Included
Period close locks the books	Not included	Included

Give finance a system that closes the month.

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