One patient, one MRN, one built-in ledger, one live command centre — from the registration counter to the operating theatre.
Why EloHIMSBilling, Invoicing & Accounting
Give every patient one clean, itemised account — whether they walk in for a single consultation or stay for a two-week admission. EloHIMS captures every chargeable event and posts each line automatically to a real double-entry general ledger. Price lists by payer, panel credit, discounts with approval, packages, instalments and doctor commission all run through the same postings.
Clinical activity becomes clean money — automatically.
Charges assemble as care happens. Consultations, procedures, investigations, pharmacy dispensing and daily bed charges all flow to a single account per visit or admission. OPD billing settles the encounter at the counter; IPD billing accrues services and bed charges across the length of stay onto one running admission account — and every line lands in the ledger under the right revenue account, with no separate bookkeeping step.
One accurate, itemised bill — already in the ledger
A running admission bill that accrues bed-days automatically
Inpatient revenue leaks quietly: a bed-day nobody charged, a procedure that never made it onto the bill, a discharge settled from memory. EloHIMS runs the inpatient bill for the whole length of stay — accruing the bed and room charge automatically each day and gathering every service, procedure, pharmacy item and investigation onto one admission account, so the discharge bill is complete, defensible and already reconciled with your accounts.
Set prices once, apply them everywhere
The pricing engine holds the rates for consultation fees, procedure and investigation charges, and room and bed classes — the full menu of what a hospital bills. Because billing draws its prices from this central setup, front-desk and ward staff never guess or hand-key a figure: they pick the service and the correct, approved price is applied automatically. Change a rate in one place and it takes effect across the hospital instantly.
The right price for who is paying — and a clean trail for what is owed
Each patient carries a payer type — cash, panel, insurance, scheme or welfare — and, for third-party payers, their panel, member number and card expiry. The price for a service is then looked up for that payer: a panel's own price first, then the price for that payer type, then the general list. Panel patients can be billed on credit, admissions can be settled in part, and leftover deposits are refunded through the cashier's shift.
Pre-authorisation and insurance claims are covered on the insurance and panels page.
Every rupee off the bill has a reason and an approver
One discount rule sits behind every bill in the hospital — OPD, procedures, pharmacy, lab, imaging, blood bank, optical and the inpatient final bill. Packages price an admission or an operation as one fee, and a balance the patient cannot clear at discharge can become a payment plan or, with an approver, a waiver.
Corrections that leave a clean, balanced trail
Corrections happen in every hospital — the honest question is whether they leave a clean trail. When a bill must be voided or a payment refunded, EloHIMS does not simply delete or overwrite: it records the reversal as a genuine double-entry movement that unwinds the original revenue and cash entries. The refund flows through the same cash and shift discipline as a collection, so it appears in the cashier's session and in the X and Z reports, and the drawer still reconciles at close.
Doctor commission worked out on every bill, not at month-end
Every charge carries the doctor responsible for it — the consultant on an OPD fee, the surgeon in theatre, the referring doctor on a lab or imaging order, the prescriber on ward medicines. Commission rules are set by doctor, by money point (OPD fees, lab, pharmacy, procedures and so on) and by department, as a percentage, a fixed amount or a per-patient amount, with a date window. The most specific rule wins, and a rule can cover every doctor.
When the hospital switches accrual on, each bill accrues the doctor's share as it is posted — on the line's net after its share of any discount — as a commission expense and an amount payable to the doctor. Voiding the bill reverses it; voiding one already paid is held back from the next payout.
The commission statement shows each doctor by money point, department and month — billed, accrued, paid, reversed and owed now. Pay a doctor directly with a payment voucher from bank or cash, or, where the HR module is part of the hospital's plan, through payroll, which picks up the accrued commission and marks it paid so it is never paid twice.
Welfare patients billed at the full rate, with who paid shown line by line
When a welfare band or fund covers part of a bill, revenue is still booked at the full tariff. The fund's share, any concession the hospital absorbs, and what the patient pays are posted as separate lines in the same voucher — so the real cost of free and subsidised care stays visible in the accounts instead of disappearing into a lower price.
An admission can follow an approved funding plan of up to four sources — funds, a sponsor's pledge, a hospital concession and the patient — each paying its part in order, with the receipt showing the cover and who funded it. The welfare desk itself is described on the charity and trust hospitals page.
Revenue lands in the ledger you choose, per department and ward
An Accounts Mapping screen lists every place hospital money goes — OPD, bed, ICU, pharmacy, lab, radiology, procedure and other revenue, plus discounts, patient deposits, doctor commission payable, panel and patient receivables, welfare funding and concessions — and lets the finance team point each one at a ledger in their own chart of accounts, by branch if needed.
A department, a ward or an OPD service can carry its own revenue ledger, which wins over the default. The screen refuses a ledger of the wrong kind — revenue cannot be pointed at a cash account — and every posting in billing, welfare and the specialty clinics follows the mapping.
Billing and bookkeeping are the same act
Most hospitals run a billing program and then re-book the numbers into offline accounting, spending their lives reconciling the seams. EloHIMS removes the seam entirely — accounting is built in, not bolted on. Every charge, payment, refund and dispense posts to a real double-entry ledger automatically, so the books are always balanced and there is no month-end reconciliation marathon.
Because pricing is central, cash is controlled and reversals are posted correctly, the revenue you expect for a given service is the revenue you actually book — right by construction.
What is a hospital management system with built-in accounting?
A hospital management system with built-in accounting is a unified platform where every clinical and financial transaction posts directly to a native general ledger using double-entry bookkeeping. Because the accounting is built in, charges, payments, refunds, and pharmacy cost-of-goods-sold (COGS) automatically generate journal entries to the chart of accounts in real time, eliminating month-end reconciliation and keeping books always balanced. Multi-branch hospitals benefit from consolidated trial balance and departmental P&L without exporting data between systems.
Why Built-in Accounting Matters for Pakistani Hospitals
Most hospital management systems in Pakistan treat billing and accounting as separate functions. The HMS generates invoices and payment receipts, then administrators manually export transaction summaries to standalone accounting software or spreadsheets at month-end. This dual-entry workflow creates three recurring problems:
- Reconciliation gaps: Cash collected in the HMS billing module doesn't match the accounting software's cash account because of timing differences, missing transfers, or data-entry errors. Administrators spend days each month investigating discrepancies.
- Pharmacy COGS blind spots: When pharmacy dispenses medication, the HMS deducts inventory quantities but doesn't post the financial cost of goods sold. Accountants manually calculate COGS from inventory reports and journal-entry it separately, risking errors and outdated cost data.
- No real-time financial visibility: Hospital directors cannot see current cash position, accounts receivable aging by insurance panel, or departmental profitability until month-end close completes, delaying decisions on credit limits, purchasing, and resource allocation.
EloHIMS eliminates these problems with native double-entry accounting. Every transaction in the system simultaneously updates clinical records and posts to the general ledger:
- Auto-posted journal entries: When a patient pays Rs 1,000 for an OPD consultation, EloHIMS debits the cashier's cash account and credits OPD revenue in real time. When pharmacy dispenses medication, the system debits pharmacy cost of goods sold and credits pharmacy inventory automatically.
- Multi-branch consolidation: Hospital groups with branches in Lahore, Karachi, and Islamabad see consolidated financial statements instantly. Each branch maintains its own chart of accounts, and EloHIMS rolls up trial balance and P&L across locations without manual export.
- Departmental P&L: Every charge links to a department (OPD, IPD, Lab, Radiology, Pharmacy). Administrators can view real-time profit and loss by department, helping identify which services are profitable and which need pricing or efficiency adjustments.
- Panel receivables: Credit bills for panels and insurers post to a panel receivables account, each panel has its own customer account and statement, and the month's bills are invoiced from that statement — straight from billing to the GL, without spreadsheet reconciliation.
- FBR and PRA integration: EloHIMS integrates with FBR digital invoicing and with PRA, so invoices are sent from the same billing screen that has already recorded the sale in the books. Read how the FBR integration works.
- Lekuka integration (Lesotho): EloHIMS connects directly to Lekuka, the e-invoicing system of Revenue Services Lesotho (RSL). Bills are signed the moment they are saved, sent to RSL in order (queued and sent automatically if the internet drops), and printed with a verification code and QR on A4 and thermal receipts, in Maloti with VAT at 15%.
Pakistani hospitals typically choose between on-premise ERP implementations that require dedicated IT staff to maintain accounting integrations, or cloud HMS platforms that treat billing and accounting as separate functions. EloHIMS delivers both capabilities in one SaaS platform: unified patient-to-payment-to-books workflow, cloud deployment with no server to run, and multi-branch readiness from day one.
Every patient gets one accurate, itemised, professional bill — and every line is already in the ledger under the right revenue account, with no separate bookkeeping step.
Explore the revenue cycle
What is the difference between accounting integration and a built-in general ledger?
Hospital software handles accounting in one of three ways: exporting reports to a spreadsheet, an integration that syncs billing summaries to separate accounting software, or a built-in general ledger where every clinical transaction posts as a double-entry journal entry inside the same system. EloHIMS uses the third approach, so the books stay balanced without external accounting software or reconciliation.
See billing and accounting run as one.
One itemised account per patient, priced centrally and posted straight to a real general ledger — no month-end reconciliation, ever.
Hospital Billing & Accounting FAQs
Answers to the questions hospitals ask us most.
What is hospital billing software?
Hospital billing software records every chargeable service — consultations, procedures, investigations, pharmacy and bed days — on the patient's account, collects payment and prints receipts. EloHIMS adds price lists by payer and panel, credit billing for panels, part payments, discounts with reasons and approval, and packages, and integrates with FBR digital invoicing and PRA. Every bill posts to its built-in double-entry general ledger automatically.
Does EloHIMS integrate with FBR and PRA?
Yes. EloHIMS integrates with FBR's digital invoicing system and with PRA (Punjab Revenue Authority), from the same billing screen that has already posted the sale to the ledger. Whether your hospital is required to integrate, and from when, is a matter for you and your tax adviser — EloHIMS provides the integration, not the determination.
Does EloHIMS work with Lekuka in Lesotho?
Yes. EloHIMS connects directly to Lekuka, the e-invoicing system of Revenue Services Lesotho (RSL). You register the Device ID and activation key RSL issues to you once in Settings, and every bill, credit note and debit note is then signed, sent to RSL and printed with its verification QR code. If the internet drops, billing continues and the signed bills are sent automatically when the connection returns.
What is double-entry accounting in hospital software?
Double-entry accounting records every transaction as both a debit and credit, ensuring the ledger always balances. In hospital software, this means every bill, payment, refund, and expense automatically posts to the general ledger (GL), eliminating month-end reconciliation. EloHIMS includes a built-in GL, trial balance, P&L, and balance sheet, unlike basic billing software requiring separate accounting tools.
Can hospital billing software handle insurance panels and corporate agreements?
Yes. Each panel, corporate, insurer or scheme has its own price list, credit limit and billing cycle, and patients carry their panel, member number and card expiry. Panel bills go on credit at the panel's price and are invoiced together from the panel's statement. For insurers and schemes, pre-authorisation is recorded on the admission and each credit bill is raised as a claim tracked through submitted, approved, resubmitted, paid or rejected.
How does hospital billing software prevent revenue leakage?
Revenue leaks when a service is never charged or a discount is given without authority. In EloHIMS, charges flow onto the patient's account from the department that provides them, prices come from one central tariff, discounts above the hospital's limit need a reason and an approver's PIN, and voids and refunds post reversals on the cashier's shift with a full audit trail.
How does built-in accounting differ from a separate accounting package?
Built-in accounting means the general ledger, chart of accounts, journal entries and trial balance live inside the hospital system itself. With a separate package, billing data has to be exported or synchronised and then reconciled. In EloHIMS every transaction posts to the ledger at the moment it happens — a payment at the counter, a dispense, a refund — so there is no export step, no second data entry and no month-end import, and the trial balance always matches the clinical transaction history.
Can a hospital management system replace standalone accounting software?
It can when it includes a full double-entry general ledger, a chart of accounts you can shape to your structure, and the standard financial reports. EloHIMS does: every bill, payment, refund, deposit and dispense posts its own voucher, an Accounts Mapping screen lets your accountant choose which ledger each kind of income and receivable posts to, and the trial balance, profit and loss and balance sheet come from the same entries as the clinical record.
What is auto-COGS posting in hospital pharmacy?
Auto-COGS (cost of goods sold) posting means the hospital management system automatically debits the COGS expense account and credits the pharmacy inventory account when medication is dispensed, at the cost of the batch issued. In manual workflows, pharmacy staff dispense medication in the HMS (which reduces inventory quantities), but the financial cost is not recorded until month-end when accountants review purchase invoices and inventory reports to calculate COGS via journal entry. This delay causes two problems: (1) profit margins are unknown until month-end, so administrators cannot identify which medications lose money due to wastage, expiry, or pricing errors, and (2) the general ledger inventory balance doesn't match physical inventory because COGS hasn't posted yet. EloHIMS solves this with real-time auto-COGS: when pharmacy dispenses a strip of paracetamol purchased at Rs 185 a strip, the system immediately debits pharmacy cost of goods sold and credits pharmacy inventory by Rs 185. Administrators see live gross profit per medication and can adjust pricing, negotiate supplier discounts, or discontinue low-margin items without waiting for month-end reports.
Does built-in accounting support multi-branch hospital groups?
Yes, hospital management systems with built-in accounting can support multi-branch groups through consolidated chart of accounts and inter-branch financial reporting. Each branch (Lahore, Karachi, Islamabad) operates its own instance with local revenue, expense, and asset accounts, and the system rolls up trial balance and P&L across all locations for group-level financial statements. EloHIMS enables multi-branch hospitals to: (1) view consolidated revenue by service line (OPD, IPD, Lab, Radiology, Pharmacy) across all branches, (2) compare departmental profitability between branches to identify underperforming locations, (3) manage centralized purchasing and inventory transfers between branches with automatic GL postings for inter-branch receivables and payables, and (4) report revenue for each facility separately as well as for the group. This eliminates the need for hospital groups to maintain separate HMS instances with manual Excel consolidation, reducing accounting workload and improving accuracy. For franchised diagnostic lab networks or hospital chains expanding across Punjab and Sindh, built-in multi-branch accounting provides the financial control structure required to scale operations without proportional increases in finance staff.
What accounting reports does EloHIMS generate automatically?
EloHIMS generates trial balance, profit and loss statement, balance sheet, cash flow statement, accounts receivable aging by insurance panel, departmental P&L, and inventory valuation reports in real time from the built-in general ledger. Because every transaction posts journal entries immediately, these reports reflect current data without waiting for month-end close or manual adjustments. Administrators can filter reports by date range, branch, department, or service line to analyze financial performance. For example, a multi-specialty hospital in Lahore can view the P&L for its cardiology department for the last quarter, compare it to the orthopedics department, and identify which service line has the highest contribution margin. Insurance panel AR aging reports show outstanding receivables from each panel broken down by current, 30 days, 60 days, and 90+ days overdue, helping billing staff prioritize collection efforts. Pharmacy managers can view inventory valuation reports showing the current book value of stock on hand, calculated using weighted-average cost from purchase transactions. These reports are accessible from the Command Centre dashboard with role-based permissions, ensuring hospital directors, CFOs, and department heads see the financial metrics relevant to their responsibilities.