Doctor Revenue & Expense

Overview

Doctor fees in NICE HMS are commission-based, not salary-based. Every billable item (test, procedure, service) can carry a commission percentage for up to two doctor roles:

• Consignee / Consultant — the attending doctor who earns commission on the item (perceatgeToLedger).
• Referring doctor (PRM) — the doctor who referred the patient (prmPercent).

The commission is stored as a percentage on each invoice line. The actual amount paid to the doctor is then booked manually through a "Doctor Expense Booking" journal voucher — NICE HMS does not auto-compute or auto-pay doctor commission.

The two doctor roles

Consignee = Consultant (attending doctor)

"Consignee" and "consultant" are the same role in NICE HMS — the doctor who attends the patient and earns commission per item. This is the encounter's attending participant (FHIR code ATND).

• The commission percentage is labelled "Percentage To Consignee Ledger" in the Item Master.
• At invoice time, each line is assigned to a consignee ledger (consigneeLedger) with its percentage (perceatgeToLedger).

A separate Consultant field on the invoice records who the MIS reports attribute the revenue to. It starts as the encounter's attending doctor and can be changed or cleared, and a blank Consultant means Hospital / direct. It is revenue attribution only: it does not change commission, which still follows ledgerId/consigneeLedger and perceatgeToLedger on each line.

Referring doctor (PRM)

A separate role — the doctor who referred the patient (FHIR participant code REF). Each item line can also carry:

• refDocName — the referring doctor's name.
• prmPercent — the referring doctor's commission percentage.

Where commission is captured

The doctor↔item↔revenue mapping lives on the item table (one row per invoice line):

The percentages are copied from the item master (ORG_PANEL_AND_TEST) when the invoice is created. See Billing Overview and Item Management.

Which month does the revenue belong to?

Doctor revenue is attributed to the voucher date (the date the invoice/receipt was recorded) — not the admission or discharge date.

• The month-wise doctor reports bucket each encounter by its last transaction date (the MAX(voucher.date) for that encounter).
• A patient admitted on 30 January and discharged on 3 February is counted in the month of their final transaction (typically when the last receipt settled the bill), not the admission month.

There is no admission-date / discharge-date logic anywhere in the doctor-revenue reports.

The zero-balance rule

Some doctor reports only include encounters that are fully settled (no outstanding balance):

Balance is computed as INVOICE + PAYMENT − CREDIT_NOTE − RECEIPT.

OPD vs IPD

Reports can be split by encounter type using the encounter display name:

• OPD visit … → outpatient
• Admission visit … → inpatient

The Encounter Month Wise report filters by encounterName LIKE 'OPD%' or 'Admission%'. The Primary Consultant Insights report covers OPD and IPD together and does not split them.

Partial payments

In the settled-report view (Consignee / PRM Month Wise), any outstanding balance excludes the entire encounter — the balance must be exactly 0. A partially paid encounter stays out of the report until it is fully settled.

The Primary Consultant Insights report ignores payment status entirely.

Reports

See MIS Reports for the full report catalogue.

How the doctor is actually paid (Doctor Expense Booking)

Doctor commission is not paid automatically. An accountant records each payment as a manual journal voucher:

1. Go to Accounts → Doctor Expense Booking (/admin/accounts/journal-doctor/).
2. Book Expense — creates a DOCTOR_EXPENSE_BOOK voucher that credits the doctor's consignee account (records the amount owed).
3. Reverse Expense — creates a DOCTOR_EXPENSE_CANCEL voucher to reverse a previously booked amount.
4. Pay from Doctor Dues — the "Payment" button opens a PAYMENT voucher to settle the balance.

The amount is whatever the accountant enters — the code does not multiply total × percent automatically.

Doctor Dues (consignee ledger balance) is computed as:

• crAmount = sum of DOCTOR_EXPENSE_BOOK + RECEIPT vouchers
• drAmount = sum of DOCTOR_EXPENSE_CANCEL + PAYMENT vouchers
• balance = crAmount − drAmount → the amount currently owed to the doctor

Key tables

Related guides

• Billing Overview — voucher groups and the accounts workflow
• MIS Reports — the full report catalogue
• Item Management — where commission % is configured
• Accounts Master — the chart of accounts (consignee ledgers)