Bhima is a free, open source accounting and hospital information management system (HIMS) tailored for rural hospitals in Africa. We are an international team based in the Democratic Republic of the Congo.
Debtors are individuals or organisations that can procure goods and services from the medical institution and are invoiced as a result. The vast majority of debtors will be patients, though other kinds of clients may also be modeled as debtors in certain contexts.
All debtors in BHIMA are organized into Debtor Groups. Debtor Groups determine the accounts and billing structure for individual debtors.
Because debtor groups are principally a financial concept, BHIMA requires certain financial information to create one. This includes:
Optional information includes:
A “convention” is a collective of individuals who are under contract with the medical institution to pay for care of individual members. It is analogous to a health management organisation (HMO). Instead of invoicing individual members of the group, the institution will invoice the group for medical care provided to any member of the group.
In BHIMA, conventions are non-cash clients. This means BHIMA will block payments at the cash window for patients that are in a convention, to prevent double-payment. Instead, conventions are expected to pay periodically in bulk for their members using journal vouchers. Using journal vouchers allows much finer-grained control over payments made by the organisation.
Hospitals often charge patients associated with organizations or health maintenance organisations (HMOs) full price to subsidize care for patients who cannot afford to pay. Conversely, some debtor groups may have agreements with the hospital to waive administrative fees.
To manage these scenarios, BHIMA provides administrators with a “group policies” feature. This feature allows administrators to configure exemptions for specific groups, overriding standard rules for subsidies, discounts, or administrative fees that would otherwise apply to individual group members.
Debtor Groups can be assigned specific fees or subsidies. For example, clients who consistently pay via mobile money platforms (e.g., M-Pesa) may incur a processing fee for each invoice. Similarly, church members might receive a subsidy sponsored by a religious organization.
The “Subscriptions” section in the debtor group management module allows administrators to configure group-specific fees and subsidies. The available subscription types include:
For more information on invoicing, see the ../bookkeeping/patient-invoices.md documentation.