CHAPTER ONE

1.0 INTRODUCTION

Hospital is health care institution or a place where people who are sick injured and wounded are
given medical treatment, surgical care and cure, while billing is a process of showing an invoice
on how much one owes or has to pay for service rendered. In summary hospital billing is amount
of money to be paid or charges given to a patient for treatment care, cure of illness and other
services render by the doctor. Hospitals are responsible for the supply of drugs to patients at
specific drug rate, but their billing has been manually processed. The aim of this project work is
to design and implement hospital billing system. Before now there have been numerous problems
faced by the hospital in operating the manual system of billing which is not very efficient, a lot of
paper work has been done, receipt, irrespective of the number of patients take long period of time
to prepare, due to the voluminous numbers of drugs used. Records of patients serve as information
for preparing management decision are very difficult to locate manually, because of these
problems errors arising from such system become very noticeable.

The hospital billing software is to hold information on patients bills in different departments in the
hospital. The development of the system is to ensure that the number of patients being attended to
on daily basis is known or track down and also at same time accounting for bills of the patients. It
helps the hospital to know with ease how much they realize. This information can be used by a
hospital to determine and calculate the average number of patient that is treated in the hospital in
a week, month or year. The total cash the hospital can make and expenditure in a particular period
of time can be determined using the figures.

1.2 STATEMENT OF THE PROBLEM

Over the year, the problems existing with the current manual processing information in the hospital
are; files and records are not properly kept due to the use of paper to keep records, inability to
search for a particular record when the need arises, slow processing of information, errors are
easily made and hardly detected, the manual system does not ensure durability of record storing
information is not well maintained and time consumption due to the use of calculator, pen and
paper to compute the patients’ bills.
1.3 AIM AND OBJECTIVES OF THE STUDY

The aim of this study is to design and implement Health care billing system for the The
Polytechnic, Health Center that will ensure efficient record process in the establishment such as:

1. To design a computerized system for managing hospital billing.

2. To design a system that will accurately compute total bill of patients.
3. To create a system that will be used to obtain reports of billing records of patients.
4. To implement a system that can be used to update billing information of patients.
5. To avoid duplication of Records.

1.4 JUSTIFICATION OF THE STUDY

The work will be beneficial to both the management and staffs within the establishment to create
awareness of billing system using the software for the calculation of bills in the health center, it
will enable the management to know the total number of patients and the payment made by patient
as the software will keep tracks of all the patients transactions with the health center. It will ensure
that patients are attended on time and a how a patient can get registered first, before the proper bill
process.

1.5 SCOPE OF THE STUDY

The scope of this project work covers design and implementation of a computerized health billing
system, it provide a program that will effectively handle the operations of the health billing system.
A program that will be interactive whereby they must be an operator (staff) to supply patients
billing data into the computer system.

1.6 METHODOLOGY

A thorough investigation of functional requirement of the present system and finding out whether
the requirements and objective of the system are being achieved was made in order to obtain
detailed facts about the application area to be re-designed. Direct observation and examination of
documents were carried out.
This involves method use for sourcing data and the programming language used in this project;

 Primary source: This involves the use of interview and observation method for data
collection. Some staffs of the case study were interviewed in his/her office in order to
know the procedure of current method and its problems.
 Secondary Source: This involves the use of internet materials, textbooks etc

The programming language used for this project is Visual Basic dot Net and the database used is
Microsoft Access 2007.

1.7 DEFINITIONS OF TERMS

 SMART CARD: A smart card is a plastic card with a built-in microprocessor, used for
electronic processes such as personal identification and financial transaction.
 DATA: Data are facts and statistics that are used for reference and analysis.
 AUTHOMATED SYSTEMS: This is the use or introduction of automatic equipment in
a manufacturing or other processes or facility
 DATA SECURITY: This is the legal control over access to and use of data stored in
computers.
 AUTHENTICATION: This is the process of identifying an individual usually, based on
a username and password. In security systems, it is the process of giving individuals access
to system objects based on their identification.
 PROTOCOL: Protocol is a set of rules governing the exchange of transmission of data
between devices.
 DATABASE: database is a standard set of data held in a computer.
 PATIENT: they are people who will be paying the fees. They are the customer of the
office
 CALCULATOR: The material to compute the fees used by the patient on the manual
billing system
 CHAPTER TWO
2.0 LITERATURE REVIEW

2.1 BACKGROUND OF THE STUDY

A lot of reference and research works have been carried out in a friendly manner. Literature,
journals and computer dictionaries have been covered based on this project topic.

Room status handled by computer is accurate, and both easily and quickly displayed. Details of
each room is stored with the memory and as a guest register; the guest list is immediately updated,
while that particular room is removed from the list of those which are available for letting. Because
the system is so accurate, there is little chance of two people being given the same room.

They also started that a hotel which operates computerised system will ensure that the program
carries provision for different tariff, locations and individual guest preference. The computer will
select the best available room for a particular reservation or offer alternatives, if the preferred room
is already taken or not yet ready. It is essential that the system is capable enough to ensure that any
special request by guest can be catered for.

They further said that: A system of departmental notifications and records has to be kept to ensure
that the needs of the guest and management are satisfied. In a hotel where computer is in use these
notifications and records pose no problem at all. A computer system will usually include a facility
to exempt a guest from constantly registering at a hotel. The system may automatically transfer
booking details into a registration document, or may be a storage system for those guests who have
stayed in the hotel before. This means that on a return visit by a guest, the computer will search
the files and reproduce the registration details. A computer may be programmed with details of
any undesirable guest who may have caused problem in the past, or been black listed. COLIN
et’al (1988)

Many establishments now use computer system with all the advantage it brings like speed,
reliability and versatility. As soon as the reservation details are entered, the computer will check
room availability and if the requirements can be met, it records the booking in its memory.
THUNHUST (1990)
Computers are also invaluable to hoteliers. Records of detailed information can be kept for all
advanced bookings, so that the hotel knows who to expect, when the guest will arrive or depart
and what kind of room is required.

They further stated that: the computer can also assist by writing the confirmation letters, keeping
messages for guests and advising the hotel manager about regular guests, so improving the level
of service the hotel offers. When a guest arrives at the hotel the same information can be used to
produce a range of information for other departments.

They equally pointed that the housekeeper also needs to know which rooms are being vacated so
that linen can be changed and the room prepared for the next arrival. It is often the mark of a
professional housekeeper to know the name of regular guests and their individual preferences.
These are often the little details which make people feel welcome and will ensure that they return
on another occasion and the computer can help by keeping all this information up to data.

Hotels with computers programmed to produce first class print out of future room and guest
occupancy have an advantage, but there is no guarantee that there will not be a power or computer
failure, and of course not all hotels have computers. It is therefore, essential that reservation staffs
are able to project an accurate hand written forecast and this requires knowledge, skill and
experience.

Stated that in the 1960s and 1970s, rapid development of electronic data processing extended the
use of computer to many walks of life and some of their most fruitful application have been in
service industries, in accounting, banking and retailing as well as in as in hotels. More recently,
microelectronic technology brought their more widespread use within reach of smaller hotel
operations. Microelectronic technology now makes possible cheap compact and reliable
electronic.

He further stated that the new technology is fast and speed is important in hotels- in responding to
guest, travel agent or tour operator inquiring about room availability, in effecting a reservation, in
linking the reservation with the registration of guest, their charges and the settlement of account,
accuracy is important in hotel.
The new technology is gradually becoming cheap to use, cheaper than ordinary office machinery
and with rising costs of clerical labour in hotels, the scope for saving may be considerable.

The main application of computer in hotels are, therefore, being extended from their establishment
role in reservation system to front office procedures and guest accounting to purchasing, stock
control and general accounting function of hotels to form integrated management information
system. (HAITER, 1994) Stated that a more complete definition of a computer is a machine that
collects, process, stores and reports data and covert data into information. They further stressed
that managers appreciate the computer speed and accuracy in financial applications because it can:

 Increase managerial effectiveness.

 Reduce operating costs
 Improve the effectiveness and efficiency of clerical workers.
 Facilitate management of cash receipts and disbursements.
 Add confidence in the reliability of data.

These machines (computers) assist their users by saving time, increasing efficiency, proving better
service to customers, reducing costs and increasing management effectiveness.

Maintain that computer in management information system can be used in preparation of

management report (because of vast processing speed of the computer) in a more appropriate time
scale for the control of operation and decision making than is possible by other means.

Stated that lodging planning is usually done manually but some experimental work has been done
on lodging planning by computer, and a high level of customer satisfaction is claimed since
computer is programmed to take account of current prices, serving on food purchased may be
achieved.

Stated that the particular applications of electronic data processing, application of electronic sales
related information may be seen in three main directions, reflecting the cycle of a guest stay from
an initial enquiry and reservation to the guest’s departure and settlement of account.

Like the density chart, a computerised reservation system keeps the inventory, showing at a glance
how many rooms of each type are available or sold for a particular night. The system also stores
of each booking (as a reservation form and a dairy dose) and these can be recalled, amended or
cancelled at anytime.

They sated the value of a computerized system lies primarily in the speed with which the
information can be handled for various purpose, even in the largest hotel in comparison with a
manual system it can be programmed to handled room number, price and a wealth of other data
including guest histories to point out confirmation of a booking for the guest; to produce arrival
and departure lists; to analyse statistics of advance booking.

Computerization may be applied to a single hotel to central reservation in which a central computer
is linked to hotel in a group and guests can reserve in one request rooms in any hotel in a group.
To make this possible, information about each hotel must be accessible to the centre or to all the
other hotels so that the total inventory may be drawn upon making reservations.

Computerization reservation follows essentially one or two basic system in a full inventory system
or a block system. The full inventory system allows and requires reservation to be allocated to a
specific room. The system is akin to the use of a conventional booking chart in common use in
resort hotels. (BEAVIS et’al, 1981).

2.2 RELATED WORKS

2.2.1 MediNous Hospital Management System
MediNous Hospital Management System provides the benefits of streamlined operations,
enhanced administration & control, superior patient care, strict cost control and improved
profitability.
 Figure 2.1: Homepage view of MediNous HMS

Figure 2.2: Patients Registration view of MediNous HMS

2.2.2 Normah Medical Specialist Centre Hospital Management System
Normah Medical Specialist Centre (NMSC) is owned by Sarawak Medical Centre Sdn Bhd, which
is a subsidiary company of the State Financial Secretary (SFS) Incorporation. The Centre was
officially opened on 11 August 1988. Apart from primary and family medicine and general
specialties like internal medicine, general surgery, obstetrics and gynaecology and paediatrics, it
also offers tertiary services such as cardiology and cardiac surgery, endoscopic surgery,
neurosurgery, urology and nephrology, haematology, psychiatry and medical oncology. NMSC
was the first hospital in the island of Borneo to offer open heart surgery in December 1994.

Figure 2.3: Homepage view of NMSC HMS [21].

Figure 2.4: Outpatient registration form view of NMSC HMS [21].
2.2.3 Hospital Kuala Lumpur Hospital Management System

Hospital Kuala Lumpur (HKL) is a main government hospital located in the state of Kuala Lumpur,
Malaysia. It has 38 different departments and units, which include the administration & finance
department, the pharmaceutical department, training and research, 23 clinical departments and 11
clinical support services [30].

Figure 2.5: Homepage view of HKL [9] .

Figure 2.6: General information of Outpatient Clinic view of HKL [9].
 Figure 2.7: General information of Medical Examination view of HKL

2.3 CURRENT METHOD IN USE

The existing systems provide the basic functionalities needed to be handled in a hospital
management environment. There is no intelligence of the software in such cases. In the existing
system all the patient details, doctor availability details and regarding the tests done to the patients
prescribed by the doctor is maintained manually by the receptionist. If a patient has to be admitted
we need to check the availability of the bed which consumes lots of time if done manually. Also
there is no proper search technique to check the patient information. It is a very difficult task to
maintain all the finance management system,and the records which maintain doctor details, of the
hospital by using this existing system. There are also many loopholes when we look at the security
of the system. These are the main disadvantages of the existing systems that are overcome in the
proposed model.

2.4 APPROACH TO BE USED IN THE STUDY

In our proposed system, we are going to provide solutions to all the above mentioned
problems by automating the whole hospital billing system by using an integrated software that
handles the whole system. The proposed system provides One Integrated View to Patients for
Billing, Collection, Discharge Detail, and Patient Medical History. Easy Query Handling for
instant decision of Bed Allocation for Patients, and request for the Bed Transfers. Effective Search
facility to search any type of information related to Patient history. Certain actions are automated,
for example, the date need not be entered explicitly by the user but instead the system adds it
automatically while storing the data. One more advantage of this newly proposed system is that
the data is processed before storage, i.e. checked for the correctness.