Billing & Claims Management Screen Requirements

Screen Inventory

Screen ID	Screen Name	Primary Actor(s)	Workflow(s)	Access Level
SCR-BILLINGCLAIMS-001	Charge Review Worklist	Charge Entry Clerk, Revenue Cycle Manager	WF-BIL-001	Users with `enter_charges`, `edit_charges`, `correct_charge_errors`
SCR-BILLINGCLAIMS-002	Claim Generation & Scrubbing	Billing Specialist, Revenue Cycle Manager	WF-BIL-002	Users with `generate_claims`, `scrub_claims`, `configure_claim_edits`
SCR-BILLINGCLAIMS-003	Claim Submission Tracker	Billing Specialist, Revenue Cycle Manager	WF-BIL-003	Users with `submit_claims`, `manage_claim_worklist`
SCR-BILLINGCLAIMS-004	Payment Posting	Payment Poster, AR Specialist, Revenue Cycle Manager	WF-BIL-004	Users with `post_payments`, `reconcile_payments`
SCR-BILLINGCLAIMS-005	Patient Account & Billing	Patient Billing Specialist, Cashier, Revenue Cycle Manager	WF-BIL-005, WF-BIL-007	Users with `manage_patient_accounts`, `process_patient_payments`
SCR-BILLINGCLAIMS-006	AR Aging Dashboard	AR Specialist, Revenue Cycle Manager	WF-BIL-004, WF-BIL-006	Users with `manage_ar_aging`, `generate_ar_reports`, `view_financial_dashboards`
SCR-BILLINGCLAIMS-007	Denial Worklist	Denial Specialist, AR Specialist, Revenue Cycle Manager	WF-BIL-006	Users with `manage_denials`, `prepare_appeals`, `submit_appeals`
SCR-BILLINGCLAIMS-008	Revenue Dashboard	Revenue Cycle Manager, Finance	WF-BIL-001–007	Users with `view_financial_dashboards`
SCR-BILLINGCLAIMS-009	Cashier / POS Collection	Cashier, Patient Billing Specialist	WF-BIL-007, WF-BIL-005	Users with `collect_payments`, `issue_receipts`

flowchart LR H["RCM Home / Billing Menu"] --> A["SCR-BILLINGCLAIMS-001 Charge Review Worklist"] H --> B["SCR-BILLINGCLAIMS-002 Claim Generation & Scrubbing"] H --> C["SCR-BILLINGCLAIMS-003 Claim Submission Tracker"] H --> D["SCR-BILLINGCLAIMS-004 Payment Posting"] H --> E["SCR-BILLINGCLAIMS-005 Patient Account & Billing"] H --> F["SCR-BILLINGCLAIMS-006 AR Aging Dashboard"] H --> G["SCR-BILLINGCLAIMS-007 Denial Worklist"] H --> I["SCR-BILLINGCLAIMS-008 Revenue Dashboard"] H --> J["SCR-BILLINGCLAIMS-009 Cashier / POS Collection"] %% Charge → Claim A -->|"All charges reviewed"| B B -->|"Claims marked ready"| C %% Submission → Payment C -->|"Payer adjudication"| D D -->|"Patient responsibility created"| E %% AR & Denials D -->|"Outstanding balances"| F D -->|"Denied/underpaid"| G G -->|"Appeal submitted"| C %% Patient-facing E -->|"Collect at counter"| J J -->|"Payment posted"| E %% Dashboards A --> I B --> I C --> I D --> I F --> I G --> I

Screen Specifications

SCR-BILLINGCLAIMS-001: Charge Review Worklist

Purpose

Worklist for reviewing, correcting, and approving charges generated from clinical systems before claim generation. Supports automated charge capture validation and manual edits.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Department Filter	Dropdown	No	Must match existing `departments.department_id`	User’s default department	Multi-select allowed
Date Range	Date range picker	Yes	`from` ≤ `to`; max 31 days span	Today	Filters by service date
Charge Status Filter	Multi-select dropdown	No	Values in (`Pending`, `Error`, `Approved`, `On Hold`)	`Pending, Error`	Drives worklist
Encounter List	Table	—	—	—	Shows encounters with at least one charge in scope
Patient Name	Text (in table)	—	—	—	From `patients` (read-only)
Emirates ID	Text (in table)	—	Format `784-YYYY-NNNNNNN-C`	—	Masked except last 3 digits for PDPL where configured
Encounter ID	Text (in table)	—	Must exist in `encounters`	—	Click opens encounter charge detail
Service Date	Date (in table)	—	Valid date	—	From `charges.service_date`
Charges Count	Integer (in table)	—	≥ 0	—	Number of charges per encounter
Charge Status	Badge (in table)	—	Enum	—	Worst status among charges (e.g., if any Error → Error)
Edit Errors	Icon / count	—	—	—	Hover shows summary of errors
CPT Code	Text input (per charge row)	Yes	Valid CPT; exists in CDM	From auto-mapping	Editable inline
ICD-10-AM Codes	Multi-select autocomplete	Yes	Codes must exist in ICD-10-AM master	From encounter diagnoses	Used for medical necessity
Modifier Codes	Multi-select dropdown	No	Valid CPT/HCPCS modifiers	From rules	Inline chips
Quantity	Numeric input	Yes	> 0; integer	1
Charge Amount (AED)	Numeric input	Yes	≥ 0; 2 decimals	From contracted rate	Editable if user has permission
Contracted Rate (AED)	Read-only	—	≥ 0	From fee schedule	Tooltip shows payer/plan
Source Module	Read-only text	—	—	From integration	e.g., CPOE, RIS, LIS
Error Details	Expandable panel	—	—	—	Lists triggered claim/charge edits
Approve Selected	Button	—	Enabled if at least one charge selected & no blocking errors	—	Sets status to Approved
Put On Hold	Button	—	Requires hold reason	—	For investigation

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 0 auto; border: 1px solid #ccc; border-radius: 8px; overflow: hidden;">
  <div style="background: #1a73e8; color: white; padding: 12px 20px; display:flex; justify-content:space-between; align-items:center;">
    <h3 style="margin: 0;">Charge Review Worklist / قائمة مراجعة الرسوم</h3>
    <div style="font-size: 12px;">Facility: Dubai General Hospital</div>
  </div>
  <div style="padding: 16px;">
    <!-- Filters -->
    <div style="display:flex; flex-wrap:wrap; gap:12px; margin-bottom: 12px;">
      <div style="flex:1 1 180px;">
        <label>Department / القسم</label><br/>
        <select style="width:100%; padding:4px;">
          <option>All</option>
          <option>Radiology</option>
          <option>Laboratory</option>
        </select>
      </div>
      <div style="flex:1 1 220px;">
        <label>Date Range / نطاق التاريخ</label><br/>
        <input type="date" style="padding:4px; width:48%;"> -
        <input type="date" style="padding:4px; width:48%;">
      </div>
      <div style="flex:1 1 200px;">
        <label>Status / الحالة</label><br/>
        <select multiple style="width:100%; padding:4px; height:60px;">
          <option selected>Pending</option>
          <option selected>Error</option>
          <option>Approved</option>
          <option>On Hold</option>
        </select>
      </div>
      <div style="flex:0 0 120px; align-self:flex-end;">
        <button style="width:100%; padding:6px 8px; background:#1a73e8; color:#fff; border:none; border-radius:4px;">Apply</button>
      </div>
    </div>

    <!-- Worklist Table -->
    <table style="width:100%; border-collapse:collapse; font-size:13px;">
      <thead>
        <tr style="background:#f5f5f5;">
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;"><input type="checkbox"/></th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Encounter</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Patient / المريض</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Emirates ID</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Service Date</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Charges</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Status</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Errors</th>
          <th style="text-align:left; padding:6px; border-bottom:1px solid #ddd;">Actions</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="padding:6px; border-bottom:1px solid #eee;"><input type="checkbox"/></td>
          <td style="padding:6px; border-bottom:1px solid #eee;">ENC-2026-00123</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">Ahmed Al-Maktoum</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">784-1990-123****-3</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">07-Feb-2026</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">3</td>
          <td style="padding:6px; border-bottom:1px solid #eee;"><span style="background:#e53935; color:#fff; padding:2px 6px; border-radius:10px; font-size:11px;">Error</span></td>
          <td style="padding:6px; border-bottom:1px solid #eee;">2</td>
          <td style="padding:6px; border-bottom:1px solid #eee;"><button style="padding:4px 8px;">Open</button></td>
        </tr>
      </tbody>
    </table>

    <!-- Footer actions -->
    <div style="margin-top:12px; display:flex; justify-content:space-between; align-items:center;">
      <div>
        <button style="padding:6px 10px; margin-right:6px; background:#1a73e8; color:#fff; border:none; border-radius:4px;">Approve Selected</button>
        <button style="padding:6px 10px; background:#fbbc04; color:#000; border:none; border-radius:4px;">Put On Hold</button>
      </div>
      <div style="font-size:12px; color:#666;">Showing 1–20 of 135 encounters</div>
    </div>
  </div>
</div>

Validation Messages

Condition	Message	Severity
Date range > 31 days	"Date range cannot exceed 31 days."	Error
No department selected but user restricted	"You do not have access to all departments. Please select a department."	Error
Invalid Emirates ID format	"Emirates ID must be in format 784-YYYY-NNNNNNN-C."	Error
CPT code not in CDM	"CPT code not found in Charge Description Master. Please select a valid code."	Error
ICD-10-AM code invalid	"Diagnosis code is not valid or inactive. Select a valid ICD-10-AM code."	Error
Charge amount < 0	"Charge amount must be zero or positive."	Error
Attempt to approve with blocking errors	"One or more selected charges have blocking errors. Resolve errors before approval."	Error
Approve with warnings only	"Some charges have warnings (non-blocking). Do you want to approve anyway?"	Warning

Actions / Buttons

Apply (filters): Refreshes worklist with selected filters.
Open (row): Opens detailed charge view for that encounter (inline panel or modal).
Approve Selected: Sets charge_status = 'Approved' for selected charges without blocking errors; logs user/time.
Put On Hold: Prompts for hold reason; sets charge_status = 'On Hold'.
Inline Save (per charge row): Saves edits to CPT, modifiers, quantity, amount; re-runs charge/claim edits.

Accessibility (WCAG 2.1 AA)

All filter controls have <label> elements and aria-label in English and Arabic where needed.
Worklist table uses <th scope="col"> and row selection announced via aria-selected.
Error badges include text (e.g., "Error") not just colour.
Keyboard: Tab through filters, arrow keys to move in table; space to toggle row checkbox; Enter to open encounter.
Screen reader region (aria-live="polite") announces filter changes and validation errors.

Responsive / Mobile

Filters stack vertically; table switches to card layout (each encounter as a card with key fields).
Inline charge editing limited on small screens; deep edits may open a full-screen modal.
Touch targets ≥ 44px height; horizontal scrolling for wide tables.

SCR-BILLINGCLAIMS-002: Claim Generation & Scrubbing

Purpose

Dashboard to aggregate encounters into claims, run claim edits (including DHA/DOH-specific rules), fix errors, and mark claims ready for submission.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Facility Filter	Dropdown	No	Must match `facilities.facility_id`	User’s default facility
Payer Filter	Dropdown	No	Must match `payers.payer_id`	All
Claim Type Filter	Dropdown	No	Enum (`Inpatient`, `Outpatient`, `ER`, `Day Case`)	All
Ready for Billing From/To	Date range picker	Yes	`from` ≤ `to`; max 60 days	Last 7 days	Based on discharge date
Claims Ready Count	Read-only badge	—	≥ 0	—	Number of encounters ready to generate
Generate Claims Button	Button	—	Enabled if at least one encounter ready	—	Triggers aggregation
Claim List Table	Table	—	—	—	Shows generated claims
Claim ID	Text	—	Exists in `claims`	—	Click to open claim detail
Patient Name	Text	—	—	—	From `patients`
Payer	Text	—	—	—	From `payers`
Total Charge Amount	Numeric	—	≥ 0	—	From `claims.total_charge_amount`
Edit Check Results	Badge / icon	—	—	—	Clean / Errors / Warnings
Error Details	Expandable list	—	—	—	From `claim_edits` engine
Fix Actions	Buttons/links	—	—	—	e.g., "Add Diagnosis", "Update Provider"
Mark as Ready	Checkbox / button	—	Only if no blocking errors	—	Sets `claim_status = 'Ready for Submission'`
Batch Submit	Button	—	Enabled if at least one claim ready	—	Navigates to Submission Tracker with pre-filter

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 20px auto; border: 1px solid #ccc; border-radius: 8px; overflow:hidden;">
  <div style="background:#1a73e8; color:#fff; padding:12px 20px; display:flex; justify-content:space-between;">
    <h3 style="margin:0;">Claim Generation & Scrubbing / إنشاء المطالبات وتنقيحها</h3>
    <div style="font-size:12px;">Clean Claim Rate: 92%</div>
  </div>
  <div style="padding:16px;">
    <!-- Filters and Generate -->
    <div style="display:flex; flex-wrap:wrap; gap:12px; margin-bottom:12px;">
      <div style="flex:1 1 180px;">
        <label>Facility / المنشأة</label><br/>
        <select style="width:100%; padding:4px;">
          <option>All</option>
          <option>Dubai General Hospital</option>
          <option>Abu Dhabi Medical Center</option>
        </select>
      </div>
      <div style="flex:1 1 180px;">
        <label>Payer / شركة التأمين</label><br/>
        <select style="width:100%; padding:4px;">
          <option>All</option>
          <option>Daman</option>
          <option>THIQA</option>
          <option>Oman Insurance</option>
        </select>
      </div>
      <div style="flex:1 1 220px;">
        <label>Discharge Date Range</label><br/>
        <input type="date" style="padding:4px; width:48%;"> -
        <input type="date" style="padding:4px; width:48%;">
      </div>
      <div style="flex:0 0 160px; align-self:flex-end;">
        <button style="width:100%; padding:6px 8px; background:#1a73e8; color:#fff; border:none; border-radius:4px;">Generate Claims</button>
      </div>
    </div>

    <!-- Summary -->
    <div style="margin-bottom:12px; font-size:13px;">
      <span style="margin-right:16px;">Encounters ready: <strong>45</strong></span>
      <span>New claims generated: <strong>40</strong></span>
    </div>

    <!-- Claim List -->
    <table style="width:100%; border-collapse:collapse; font-size:13px;">
      <thead>
        <tr style="background:#f5f5f5;">
          <th style="padding:6px; border-bottom:1px solid #ddd;"><input type="checkbox"/></th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:left;">Claim ID</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:left;">Patient</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:left;">Payer</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:right;">Total Charges (AED)</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:left;">Edit Status</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:left;">Errors/Warnings</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:left;">Actions</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="padding:6px; border-bottom:1px solid #eee;"><input type="checkbox"/></td>
          <td style="padding:6px; border-bottom:1px solid #eee;">CLM-2026-00045</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">Fatima Al-Nahyan</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">Daman</td>
          <td style="padding:6px; border-bottom:1px solid #eee; text-align:right;">3,250.00</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">
            <span style="background:#e53935; color:#fff; padding:2px 6px; border-radius:10px; font-size:11px;">Errors</span>
          </td>
          <td style="padding:6px; border-bottom:1px solid #eee;">Missing primary diagnosis; Invalid modifier</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">
            <button style="padding:3px 6px; font-size:12px;">Fix</button>
          </td>
        </tr>
      </tbody>
    </table>

    <!-- Footer -->
    <div style="margin-top:12px; display:flex; justify-content:space-between; align-items:center;">
      <div>
        <button style="padding:6px 10px; margin-right:6px; background:#1a73e8; color:#fff; border:none; border-radius:4px;">Mark Selected as Ready</button>
        <button style="padding:6px 10px; background:#34a853; color:#fff; border:none; border-radius:4px;">Batch Submit</button>
      </div>
      <div style="font-size:12px; color:#666;">Showing 1–20 of 40 claims</div>
    </div>
  </div>
</div>

Validation Messages

Condition	Message	Severity
No encounters ready	"No encounters are ready for claim generation in the selected range."	Info
Missing attending provider	"Attending provider is required for this claim."	Error
Missing primary diagnosis	"Primary ICD-10-AM diagnosis is required."	Error
Payer-specific format error (DHA)	"DHA eClaimLink: Missing or invalid prior authorization number."	Error
Payer-specific format warning	"DOH eClaims: Service date more than 90 days old. Timely filing risk."	Warning
Attempt to mark ready with blocking errors	"Resolve all blocking errors before marking claim as ready."	Error
Batch submit with no ready claims	"Select at least one claim with status 'Ready for Submission'."	Error

Actions / Buttons

Generate Claims: Runs aggregation logic; creates/updates claims and claim_lines; runs claim edits.
Fix: Opens claim detail with inline guidance to resolve specific errors.
Mark Selected as Ready: Sets claim_status to Ready for Submission for selected claims without blocking errors.
Batch Submit: Navigates to Submission Tracker with selected claims pre-loaded into a new submission batch.

Accessibility

Edit status badges include aria-label (e.g., "3 errors, 1 warning").
Error details expandable region uses aria-expanded and aria-controls.
Keyboard: Space toggles selection; Enter activates "Fix".
Screen reader announces when claim generation completes and how many claims were created.

Responsive / Mobile

Claim table becomes stacked cards; each card shows Claim ID, patient, payer, status, and key actions.
Batch actions appear in a bottom fixed bar on small screens.
Filters collapse into a "Filters" accordion.

SCR-BILLINGCLAIMS-003: Claim Submission Tracker

Purpose

Monitor claim submission batches and individual claim statuses across DHA eClaimLink, DOH eClaims, and other channels; support resubmission of rejected claims.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Submission Batches Table	Table	—	—	—	High-level batch view
Batch ID	Text	—	—	—	Generated by system
Submission Channel	Dropdown / text	—	Enum (`DHA eClaimLink`, `DOH eClaims`, `Portal`, `Manual`)	—	From `Claim Submission Channels` master
Payer Filter	Dropdown	No	Must match `payers.payer_id`	All
Status Filter	Multi-select	No	Enum (`Pending`, `Submitted`, `Accepted`, `Rejected`, `Partially Accepted`)	`Pending, Rejected`
Submission Date	Date	—	Valid date	—
Gateway Response	Text	—	—	—	Summary of last response
Resubmit Button	Button	—	Enabled for rejected/failed claims	—

Validation Messages

Condition	Message	Severity
Resubmit without changes	"You are resubmitting a claim without correcting the previous rejection reason. Continue?"	Warning
Channel offline	"Selected submission channel is currently unavailable. Please try again later."	Error
Missing mandatory channel mapping	"No submission configuration found for this payer and channel."	Error

Actions / Buttons

View Batch Details: Opens list of claims within batch.
Resubmit: Creates new claim_submissions record; sends claim to selected channel.
Export Batch Log: Exports submission log to CSV/PDF for audit.

Accessibility

Status icons include text labels and aria-label with full status.
Live region announces when new responses are received (e.g., background polling).

Responsive / Mobile

Batch table becomes list view; tapping a batch opens details.
Resubmit action available via overflow menu on each claim row.

SCR-BILLINGCLAIMS-004: Payment Posting

Purpose

Interface for importing and reviewing remittance advice (ERA/EOB), matching payments to claims, posting payments and adjustments, and reconciling with bank deposits.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Remittance List	Table	—	—	—	From `remittance_advice`
Remittance ID	Text	—	Exists in `remittance_advice`	—
Payer	Text	—	—	—
Remittance Date	Date	—	Valid date	—
Total Paid	Numeric	—	≥ 0	—
Status	Badge	—	Enum (`Imported`, `In Progress`, `Posted`, `Error`)	—
Claim Match	Badge	—	—	—	% of lines auto-matched
Payment Amount	Numeric input	Yes	≥ 0	From ERA	Per claim/line
Adjustment Codes	Multi-select dropdown	No	Valid CARC/RARC codes	—
Patient Balance	Numeric (read-only)	—	≥ 0	Calculated
Post Button	Button	—	Enabled when remittance balanced	—	Posts payments
Batch Processing	Checkbox	—	—	Unchecked	For auto-posting rules

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 20px auto; border: 1px solid #ccc; border-radius: 8px; overflow:hidden;">
  <div style="background:#1a73e8; color:#fff; padding:12px 20px;">
    <h3 style="margin:0;">Payment Posting / ترحيل المدفوعات</h3>
  </div>
  <div style="padding:16px;">
    <!-- Remittance List -->
    <table style="width:100%; border-collapse:collapse; font-size:13px; margin-bottom:12px;">
      <thead>
        <tr style="background:#f5f5f5;">
          <th style="padding:6px; border-bottom:1px solid #ddd;">Remittance</th>
          <th style="padding:6px; border-bottom:1px solid #ddd;">Payer</th>
          <th style="padding:6px; border-bottom:1px solid #ddd;">Date</th>
          <th style="padding:6px; border-bottom:1px solid #ddd; text-align:right;">Total Paid (AED)</th>
          <th style="padding:6px; border-bottom:1px solid #ddd;">Match</th>
          <th style="padding:6px; border-bottom:1px solid #ddd;">Status</th>
          <th style="padding:6px; border-bottom:1px solid #ddd;">Actions</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="padding:6px; border-bottom:1px solid #eee;">ERA-2026-0012</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">THIQA</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">06-Feb-2026</td>
          <td style="padding:6px; border-bottom:1px solid #eee; text-align:right;">125,430.50</td>
          <td style="padding:6px; border-bottom:1px solid #eee;">92% matched</td>
          <td style="padding:6px; border-bottom:1px solid #eee;"><span style="background:#fbbc04; padding:2px 6px; border-radius:10px; font-size:11px;">In Progress</span></td>
          <td style="padding:6px; border-bottom:1px solid #eee;"><button style="padding:3px 6px; font-size:12px;">Open</button></td>
        </tr>
      </tbody>
    </table>

    <!-- Selected Remittance Detail (simplified) -->
    <h4 style="margin-top:0;">ERA-2026-0012 Details</h4>
    <table style="width:100%; border-collapse:collapse; font-size:12px;">
      <thead>
        <tr style="background:#f5f5f5;">
          <th style="padding:4px; border-bottom:1px solid #ddd;">Claim</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Patient</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Billed</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Allowed</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Paid</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Adj Codes</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Patient Resp.</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="padding:4px; border-bottom:1px solid #eee;">CLM-2026-00045</td>
          <td style="padding:4px; border-bottom:1px solid #eee;">Fatima Al-Nahyan</td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;">3,250.00</td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;">2,800.00</td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;"><input type="number" value="2,500.00" style="width:80px;"/></td>
          <td style="padding:4px; border-bottom:1px solid #eee;">
            <select style="font-size:11px;">
              <option value="">--</option>
              <option>45 - Charge exceeds fee schedule</option>
              <option>PR - Patient responsibility</option>
            </select>
          </td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;">300.00</td>
        </tr>
      </tbody>
    </table>

    <div style="margin-top:10px; display:flex; justify-content:space-between; align-items:center;">
      <div>
        <label><input type="checkbox"/> Enable batch auto-posting for fully matched lines</label>
      </div>
      <div>
        <button style="padding:6px 10px; background:#34a853; color:#fff; border:none; border-radius:4px;">Post Remittance</button>
      </div>
    </div>
  </div>
</div>

Validation Messages

Condition	Message	Severity
Remittance total ≠ sum of line payments	"Remittance is out of balance. Adjust line amounts or adjustments to match total paid."	Error
Payment amount < 0	"Payment amount must be zero or positive."	Error
Missing adjustment code where required	"Adjustment code is required when adjustment amount is non-zero."	Error
Posting without bank deposit date	"Bank deposit date is recommended before posting for reconciliation."	Warning
Duplicate remittance import	"This remittance file appears to be a duplicate (same payer, date, and reference)."	Error

Actions / Buttons

Open (remittance): Loads remittance detail and associated claims.
Post Remittance: Creates payments and payment_allocations, updates claims and claim_lines paid/adjusted amounts, and updates patient responsibility.
Enable batch auto-posting: Applies configured auto-post rules (e.g., auto-post if payment = allowed and no denials).

Accessibility

Table headers with scope="col"; numeric columns right-aligned but announced with context.
Error summary region at top of detail section with links to problematic lines.
Keyboard: Arrow keys navigate cells; Enter to edit numeric fields; Esc to cancel edit.

Responsive / Mobile

Remittance list as cards; detail lines grouped by claim with collapsible sections.
Posting button fixed at bottom on small screens.

SCR-BILLINGCLAIMS-005: Patient Account & Billing

Purpose

Provide a complete view of a patient’s financial account, including encounter charges, insurance payments, patient balance, statement history, and payment plan management. Supports PDPL-compliant display and patient communications.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Patient Search	Search box (MRN/Name/Emirates ID)	Yes	Min 2 chars; Emirates ID format if used	—	Autocomplete with patient list
Patient Banner	Read-only panel	—	—	—	Shows name, MRN, Emirates ID (masked), mobile, payer
Account Summary	Read-only panel	—	—	—	Total charges, insurance payments, adjustments, patient balance
Encounter Charges Table	Table	—	—	—	Per encounter
Insurance Payments	Table	—	—	—	From `payments`/`payment_allocations`
Patient Balance	Numeric	—	≥ 0	—	Calculated
Statement History	Table	—	—	—	From `patient_invoices`
Payment Plan	Form	No	If created, required fields	—	Installment amount, frequency, start date
Collect Payment	Button	—	Enabled if balance > 0	—	Opens payment collection (or POS screen)

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 20px auto; border: 1px solid #ccc; border-radius: 8px; overflow:hidden;">
  <div style="background:#1a73e8; color:#fff; padding:12px 20px;">
    <h3 style="margin:0;">Patient Account & Billing / حساب المريض والفوترة</h3>
  </div>
  <div style="padding:16px;">
    <!-- Search -->
    <div style="margin-bottom:12px;">
      <label>Search Patient / بحث عن مريض</label><br/>
      <input type="text" placeholder="Name, MRN, or Emirates ID" style="width:60%; padding:6px;"/>
      <button style="padding:6px 10px; margin-left:6px; background:#1a73e8; color:#fff; border:none; border-radius:4px;">Search</button>
    </div>

    <!-- Patient Banner -->
    <div style="background:#f0f4f8; padding:10px; border-radius:4px; margin-bottom:12px; display:flex; justify-content:space-between; font-size:13px;">
      <div>
        <strong>Ahmed Al-Maktoum</strong> (MRN: 1002345)<br/>
        Emirates ID: 784-1985-123****-1<br/>
        Mobile: +971 50 123 4567
      </div>
      <div style="text-align:right;">
        Primary Payer: Daman<br/>
        Plan: Enhanced<br/>
        Financial Class: Insured
      </div>
    </div>

    <!-- Account Summary -->
    <div style="display:flex; gap:12px; margin-bottom:12px; font-size:13px;">
      <div style="flex:1; background:#fafafa; padding:8px; border-radius:4px;">
        <div>Total Charges</div>
        <div style="font-size:18px; font-weight:bold;">AED 18,500.00</div>
      </div>
      <div style="flex:1; background:#fafafa; padding:8px; border-radius:4px;">
        <div>Insurance Payments</div>
        <div style="font-size:18px; font-weight:bold;">AED 14,200.00</div>
      </div>
      <div style="flex:1; background:#fafafa; padding:8px; border-radius:4px;">
        <div>Adjustments</div>
        <div style="font-size:18px; font-weight:bold;">AED 1,300.00</div>
      </div>
      <div style="flex:1; background:#fff3cd; padding:8px; border-radius:4px;">
        <div>Patient Balance</div>
        <div style="font-size:18px; font-weight:bold; color:#c00;">AED 3,000.00</div>
      </div>
    </div>

    <!-- Encounters & Statements (simplified) -->
    <h4>Encounters / الزيارات</h4>
    <table style="width:100%; border-collapse:collapse; font-size:12px; margin-bottom:10px;">
      <thead>
        <tr style="background:#f5f5f5;">
          <th style="padding:4px; border-bottom:1px solid #ddd;">Encounter</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Date</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Charges</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Insurance Paid</th>
          <th style="padding:4px; border-bottom:1px solid #ddd; text-align:right;">Patient Balance</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="padding:4px; border-bottom:1px solid #eee;">ENC-2026-00123</td>
          <td style="padding:4px; border-bottom:1px solid #eee;">05-Feb-2026</td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;">5,000.00</td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;">4,000.00</td>
          <td style="padding:4px; border-bottom:1px solid #eee; text-align:right;">1,000.00</td>
        </tr>
      </tbody>
    </table>

    <h4>Statements / الكشوفات</h4>
    <table style="width:100%; border-collapse:collapse; font-size:12px; margin-bottom:10px;">
      <thead>
        <tr style="background:#f5f5f5;">
          <th style="padding:4px; border-bottom:1px solid #ddd;">Statement #</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Date</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Amount</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Delivery</th>
          <th style="padding:4px; border-bottom:1px solid #ddd;">Status</th>
        </tr>
      </thead>
      <tbody>
        <tr>
          <td style="padding:4px; border-bottom:1px solid #eee;">ST-2026-0005</td>
          <td style="padding:4px; border-bottom:1px solid #eee;">06-Feb-2026</td>
          <td style="padding:4px; border-bottom:1px solid #eee;">AED 3,000.00</td>
          <td style="padding:4px; border-bottom:1px solid #eee;">SMS + Portal</td>
          <td style="padding:4px; border-bottom:1px solid #eee;">Sent</td>
        </tr>
      </tbody>
    </table>

    <!-- Payment Plan & Collect -->
    <div style="display:flex; justify-content:space-between; align-items:center; margin-top:10px;">
      <div style="font-size:13px;">
        <strong>Payment Plan / خطة الدفع</strong><br/>
        <label><input type="checkbox"/> Create payment plan</label>
      </div>
      <div>
        <button style="padding:6px 10px; background:#34a853; color:#fff; border:none; border-radius:4px;">Collect Payment</button>
      </div>
    </div>
  </div>
</div>

Validation Messages

Condition	Message	Severity
Patient not found	"No patient found matching the search criteria."	Info
Payment plan amount ≤ 0	"Installment amount must be greater than zero."	Error
Payment plan start date in past	"Payment plan start date cannot be in the past."	Error
Attempt to collect payment with zero balance	"Patient has no outstanding balance."	Info
PDPL masking rule	"You are not authorised to view full Emirates ID. Masked view applied."	Info

Actions / Buttons

Search: Finds patient and loads account data.
Collect Payment: Opens SCR-BILLINGCLAIMS-009 (POS) with patient context and amount due.
Create Payment Plan: Opens form to define installments; saves to patient account.

Accessibility

Patient banner fields exposed with clear labels for screen readers.
Tables support row-by-row reading; summary figures announced with context (e.g., "Patient balance: AED 3,000").
Search input has aria-autocomplete="list" and aria-expanded for suggestions.

Responsive / Mobile

Account summary tiles stack vertically.
Tables become collapsible lists per encounter/statement.
Collect Payment button fixed at bottom for quick access.

SCR-BILLINGCLAIMS-006: AR Aging Dashboard

Purpose

Visual dashboard showing AR aging buckets, payer breakdown, and trends, with ability to drill down to underlying claims and generate follow-up worklists.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Snapshot Date	Date picker	Yes	≤ today	Today	Uses `ar_aging.snapshot_date`
Facility Filter	Dropdown	No	Valid facility	All
Payer Breakdown Chart	Bar/pie chart	—	—	—	Visual AR by payer
Aging Buckets	Tiles/table	—	—	—	0–30, 31–60, 61–90, 91–120, >120
Total AR	Numeric	—	≥ 0	—	Sum of outstanding
Aging Trends	Line chart	—	—	—	AR over time
Drill Down to Claims	Link/button	—	—	—	Opens filtered claim list
Follow-up Worklist	Table	—	—	—	For AR Specialist

Validation Messages

Condition	Message	Severity
No AR data for date	"No AR snapshot available for the selected date."	Info
Snapshot date in future	"Snapshot date cannot be in the future."	Error

Actions / Buttons

Refresh: Reloads dashboard with selected filters.
Export: Exports AR summary to Excel/PDF.
Create Worklist: Generates follow-up tasks for selected bucket/payer.

Accessibility

Charts provide data tables with same information for screen readers.
Colour-coded buckets also labelled with text (e.g., ">120 days").

Responsive / Mobile

Charts stack vertically; some charts may be hidden behind tabs.
Drill-down opens a simplified claim list optimised for mobile.

SCR-BILLINGCLAIMS-007: Denial Worklist

Purpose

Central worklist for denied and underpaid claims, showing denial reasons, amounts, days to file, and appeal status. Supports prioritisation and appeal initiation.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Denied Claims Table	Table	—	—	—	From `claim_responses`, `denial_codes`
Claim ID	Text	—	—	—
Payer	Text	—	—	—
Denial Reason	Text	—	—	—	Categorised (eligibility, auth, coding, etc.)
Amount	Numeric	—	≥ 0	—	Denied amount
Appeal Status	Dropdown	No	Enum (`Not Started`, `In Progress`, `Submitted`, `Overturned`, `Upheld`)	`Not Started`
Days to File	Numeric	—	≥ 0	—	Based on payer rules
Appeal Button	Button	—	Enabled if appeal window open	—	Opens appeal form

Validation Messages

Condition	Message	Severity
Appeal after filing deadline	"Appeal filing deadline has passed for this claim."	Error
Missing documentation	"Attach required clinical documentation before submitting appeal."	Error

Actions / Buttons

Appeal: Opens appeal creation form; captures reason, documentation, and channel.
Update Appeal Status: Manually update based on payer response.
Send to Denial Analysis: Flag for trend analysis.

Accessibility

Days to file highlighted with text and aria-label (e.g., "3 days remaining to file appeal").
Keyboard shortcuts for changing appeal status.

Responsive / Mobile

Worklist as cards sorted by amount and days to file; appeal button prominent.

SCR-BILLINGCLAIMS-008: Revenue Dashboard

Purpose

Executive dashboard summarising total charges, collections, net revenue, collection rate, denial rate, AR days, payer mix, and trends, with drill-down by facility, department, and payer.

Field Specifications

Field	Type	Required	Validation	Default
Date Range	Date range picker	Yes	`from` ≤ `to`; max 12 months	Last 3 months
Facility Filter	Dropdown	No	Valid facility	All
Department Filter	Dropdown	No	Valid department	All
Total Charges	Numeric tile	—	≥ 0	—
Total Collections	Numeric tile	—	≥ 0	—
Net Revenue	Numeric tile	—	≥ 0	—
Collection Rate	Percentage tile	—	0–100%	—
Denial Rate	Percentage tile	—	0–100%	—
AR Days	Numeric tile	—	≥ 0	—
Payer Mix Chart	Pie chart	—	—	—
Trends	Line/column charts	—	—	—

Validation Messages

Condition	Message	Severity
Date range > 12 months	"Reporting period cannot exceed 12 months."	Error

Actions / Buttons

Drill-down: Clicking a tile or chart segment opens detailed report (e.g., list of claims).
Export: Export dashboard data to Excel/PDF.

Accessibility

All charts have data table equivalents.
Tiles include descriptive text for screen readers (e.g., "Collection rate 95 percent, target 95 percent").

Responsive / Mobile

Tiles appear first; charts accessible via swipeable tabs.
Drill-down opens simplified lists.

SCR-BILLINGCLAIMS-009: Cashier / POS Collection

Purpose

Streamlined interface for point-of-service collection of co-payments and other patient payments, with integrated receipt generation and end-of-day reconciliation.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Patient Search	Text input	Yes	Min 2 chars; Emirates ID format if used	—	Can also be pre-populated from Patient Access
Amount Due	Numeric (read-only)	—	≥ 0	From patient account
Custom Amount to Collect	Numeric input	Yes	≥ 0; ≤ amount due (unless overpayment allowed)	Amount due
Payment Method	Dropdown	Yes	Must be one of `Payment Method Types`	—	Cash, credit, debit, bank transfer, online, etc.
Amount Collected	Numeric input	Yes	≥ 0	Same as custom amount
Receipt Print	Button	—	Enabled after successful payment	—	Prints bilingual receipt
End-of-Day Reconciliation	Button	—	Cashier role only	—	Summarises payments by method

Validation Messages

Condition	Message	Severity
Amount collected > amount due	"Collected amount exceeds amount due. Confirm if this is an advance payment or deposit."	Warning
Payment method not selected	"Select a payment method."	Error
Zero amount collected	"Payment amount must be greater than zero."	Error

Actions / Buttons

Collect Payment: Creates patient_payments record, updates patient balance.
Print Receipt: Generates bilingual EN/AR receipt with PDPL-compliant masking.
Send Digital Receipt: Sends SMS/email receipt via integrated messaging.

Accessibility

Large, high-contrast buttons for payment actions.
Clear focus order for quick keyboard operation at busy front desks.

Responsive / Mobile

Optimised for tablet devices at POS; large inputs and buttons.
Minimal scrolling; key fields visible without scrolling in landscape mode.

Common UI Patterns

Displayed on all patient-specific screens (Charge Review detail, Patient Account, POS).
Fields:
Patient name (EN + optional AR)
MRN
Emirates ID (masked according to PDPL and facility policy)
Date of birth, age
Mobile number
Primary payer and plan
Behaviour:
Clickable to open full patient summary (from ehr-patient-mgmt).
Uses high contrast and clear typography.
Accessibility:
Exposed as a landmark region (role="banner").
Screen reader text includes "Patient: [Name], MRN [MRN], Emirates ID masked."

Search Components

Used for patient search, payer filter, department filter, etc.
Patterns:
Autocomplete with minimum character threshold (2–3 chars).
Debounced requests (300–500 ms).
Clear button to reset search.
Validation:
Inline messages for "no results" vs. "too many results".
Accessibility:
aria-autocomplete="list", aria-controls for result list.
Keyboard navigation: Up/Down to move in suggestions, Enter to select.

Alert / Notification Patterns

Types:
Error (red): blocking issues (e.g., missing mandatory fields).
Warning (amber): non-blocking but important (e.g., timely filing risk).
Info (blue): informational (e.g., PDPL masking applied).
Success (green): confirmation (e.g., payment posted).
Placement:
Global alerts at top of screen.
Inline field-level messages under the field.
Accessibility:
Global alerts announced via aria-live="assertive" for errors, polite for others.
Icons always accompanied by text labels.

Loading States

Use skeleton loaders for tables and dashboards.
Show concise text such as "Loading claims…" with spinner.
For long-running operations (e.g., batch claim generation), show progress indicator and allow user to navigate away while process continues in background, with notification when complete.

Arabic/English Bilingual UI Considerations

All labels and key actions available in English and Arabic; facility can configure default language per user.
Support right-to-left (RTL) layout for Arabic:
When Arabic is primary, align text right and flip layout where appropriate.
Ensure numeric values (amounts, dates) remain easily readable.
Receipts, statements, and patient-facing content:
Bilingual headers and key fields (e.g., "Amount Due / المبلغ المستحق").
Date and number formats:
Use day-month-year (e.g., 07-Feb-2026) and AED currency formatting.
Accessibility:
lang="ar" set for Arabic text blocks.
Screen readers correctly switch language context.

```

Billing & Claims Management Screen Requirements

Screen Inventory

Navigation Flow

Screen Specifications

SCR-BILLINGCLAIMS-001: Charge Review Worklist

Field Specifications

HTML Wireframe Mockup

Validation Messages

Actions / Buttons

Accessibility (WCAG 2.1 AA)

Responsive / Mobile

SCR-BILLINGCLAIMS-002: Claim Generation & Scrubbing

Field Specifications

HTML Wireframe Mockup

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-003: Claim Submission Tracker

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-004: Payment Posting

Field Specifications

HTML Wireframe Mockup

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-005: Patient Account & Billing

Field Specifications

HTML Wireframe Mockup

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-006: AR Aging Dashboard

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-007: Denial Worklist

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-008: Revenue Dashboard

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-BILLINGCLAIMS-009: Cashier / POS Collection

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

Common UI Patterns

Patient Banner

Search Components

Alert / Notification Patterns

Loading States

Arabic/English Bilingual UI Considerations