> ## Documentation Index
> Fetch the complete documentation index at: https://docs.sigmahmis.com/llms.txt
> Use this file to discover all available pages before exploring further.
# From Patient Visit to Confirmed Invoice in Sigma HMIS
> Walk through registering a patient, opening an encounter, attaching charges, and confirming an invoice ready for claim submission.
This workflow covers the full path from a patient arriving at the clinic to a confirmed, ready-to-claim invoice in Sigma. Follow each step in order to keep the encounter record, charges, and invoice linked — so nothing falls through the gap between care and billing.
Search for the patient by name, ID number, or date of birth in the Patient Directory. If a record exists, open it and verify that the insurer scheme membership is current before proceeding.
If the patient is new, create a record with the following details:
* Full name and date of birth
* National ID or passport number
* Contact details (phone number, address)
* Insurer scheme name and membership number
Accurate scheme details at registration prevent claim rejections later in the process.
From the patient record, click **New Encounter**. Fill in the encounter header:
* **Date** — The date of the visit (defaults to today)
* **Treating clinician** — Select from your active provider list
* **Encounter type** — Choose the appropriate category: consultation, procedure, emergency, follow-up, or other
Save the encounter header before attaching charges. This locks the visit context so every charge is tied to the same date and provider.
Add each service, procedure, or medication delivered during the encounter. Use the charge search to find items by name or billing code.
For each item Sigma automatically applies:
* The tariff amount from the patient's scheme fee schedule
* The applicable billing code (procedure, diagnosis, or dispensing code)
* The quantity (edit this if more than one unit was delivered)
Continue adding lines until every item delivered during the visit is captured. Do not close the encounter until the charge list is complete.
Sigma calculates the **scheme portion** and the **patient co-payment portion** for each line based on the patient's benefit rules. Before confirming, verify:
* The scheme code on the invoice matches the patient's current membership
* The scheme portion and patient portion add up to the total charge
* Any items not covered by the scheme are correctly marked as patient-responsible
If the scheme code is wrong, update the patient record and re-apply the fee schedule before proceeding.
Click **Review Invoice** to see the full summary — line items, totals, scheme split, and patient balance. When everything is correct, click **Confirm Invoice**.
Confirming the invoice:
* Locks the line items so they cannot be edited without an adjustment record
* Links the invoice permanently to the encounter
* Moves the invoice to **Ready for Claim** status
A confirmed invoice is immediately available for claim preparation in the Claims module.
If the patient owes a co-payment, collect it before they leave. Open the **Payments** tab on the confirmed invoice, enter the amount received, and select the payment method (cash, card, mobile money, or other).
Recording the co-payment at point of visit closes the patient-side balance and prevents it from appearing as an outstanding debt in the revenue reports.
## What Happens After Confirmation
The confirmed invoice is linked to the encounter record and immediately visible in the Claims module — no re-entry of visit or billing data is needed. Your billing team can open the invoice and start a claim directly from the same record. The visit, charges, and claim all share a single audit trail from this point forward.
Confirm invoices before the patient leaves whenever possible. Charges are most accurate when attached at the time of care, and same-day confirmation means your billing team can start the claim the same day.
If you need to adjust a confirmed invoice — for example, to add a missed charge or correct a billing code — use the **Adjustment** function from the invoice record. Do not create a duplicate invoice. A duplicate will appear as a separate submission in Claims and may trigger a double-payment error with the insurer.
## Related
Manage fee schedules, invoice settings, and encounter charge configuration.
Prepare, validate, and submit an insurance claim from a confirmed invoice.
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