medOS Financial

Scope: Billing, invoicing, sales orders, accounts receivable, RCM, and product/pricing master data.

The medOS Financial service (ever-api-financial) owns the money side of the patient lifecycle. It turns clinical activity into priced sales orders, accumulates them into invoices and claims, tracks accounts receivable through to settlement, and reconciles payments against payor and bank channels. It also holds the product/pricing master data and the rule engines that tag and optimize charges for revenue-cycle management (RCM). The service runs as a NestJS + Moleculer microservice on NATS and writes to MongoDB as its primary store.

~34

modules

ever-api-financial

internal scope

internal

default port

NATS

message broker

Responsibilities

• Charge capture and sales orders — materialize priced order lines from clinical/diagnostic/medication activity, with auto-close scheduling for open orders.
• Invoicing and claims — assemble invoices and payor-specific claim invoices for submission.
• Accounts receivable — manage the AR lifecycle, installment plans, and progression stages.
• Collections and settlement — drive debt collection, revenue collection, receipts, bill-cycle settlement, and reconciliation.
• Payor management — model payors, plans, enrollments, schemas, and Thai insurance classifications (Inscl / sub-Inscl).
• Product and pricing master data — maintain the product catalog, discount items, and tax rules used to price every line.
• RCM intelligence — validate coding output, auto-tag charges, and surface revenue-optimization opportunities.
• External connectors — bridge to e-Claim, HIPData, and bank/payor transaction channels.

Major modules

Module	Purpose
salesOrder	Priced order lines per encounter; auto-close scheduling
invoice	Invoice assembly from sales orders
claimInvoice	Payor-specific claim invoice generation
accountReceivable	AR records and settlement ledger
accountReceivableInstallment	Installment / payment-plan tracking
accountReceivableStage	AR progression state machine
accountAccount	Chart-of-account style account records
accountAssetCategory	Asset categorization
billingGroup / billingSubGroup	Billing taxonomy for charge routing
billCycleSettlement	Periodic bill-cycle settlement runs
receipt	Payment receipts
settlement	Settlement records
reconciliation	Payment-to-claim reconciliation
revenueCollection	Revenue collection pipeline / exports
debtCollection	Outstanding-debt collection workflow
disbursementGroup / disbursementSubGroup	Disbursement taxonomy
payor	Payor master
payorPlan / payorPlanEnrollment	Plans and patient enrollment
payorInscl / payorPlanSubInscl	Insurance classification (Thai สิทธิ)
payorSchema	Per-payor configuration schema
product	Product / service catalog and pricing
discountItem	Discount line items
tax	Tax rules
orCaseCosting	Operating-room case costing
socialWork	Social-welfare / charity coverage
wallet	Patient wallet / deposit balances
rcmValidation	Validation over coding output
nhsoAutoTagger	Auto-tagging of charges for NHSO claims
revenueOptimizer	Revenue-optimization opportunity surfacing
eclaimConnector	e-Claim submission connector
hipdataConnector	HIPData integration connector
krungthaiTransaction	Bank transaction channel
ktbDirectLinkTransaction	Bank Direct Link transaction channel
ePhis	E-PHIS reporting integration

Charge-to-settlement flow

Clinical / Diagnostic / Medication activity
            │  (Moleculer events over NATS)
            ▼
        salesOrder ──── product · discountItem · tax  (pricing master)
            │
            ▼
        invoice ──▶ claimInvoice ──▶ eclaimConnector / hipdataConnector
            │                              │
            ▼                              ▼
   accountReceivable ◀──── reconciliation ◀── payor response / bank txn
            │
            ├─ accountReceivableInstallment
            ├─ accountReceivableStage
            ▼
   receipt · settlement · billCycleSettlement ──▶ revenueCollection

Events & integration

• Communicates with the rest of the platform over NATS via the Moleculer service mesh; emits and consumes domain events (for example, sales-order lifecycle events and a coding-completed listener that feeds RCM validation).
• A financial cache-clean event mixin keeps cached pricing/AR state consistent on upstream changes.
• Payor and bank connectors (eclaimConnector, hipdataConnector, krungthaiTransaction, ktbDirectLinkTransaction) provide outbound submission and inbound transaction reconciliation.

Pricing

Product master

Catalog, discounts, and tax rules price every sales-order line.

RCM

Validation & optimization

rcmValidation, nhsoAutoTagger, and revenueOptimizer harden claims before submission.

Recovery

AR & collections

Installments, AR stages, debt collection, and reconciliation close the loop to settlement.

Related pages

• Backend overview
• Architecture overview
• FHIR integration

Related catalog items

• FIN-1 … FIN-10 — Financial / RCM
• INT-22, INT-23 — Bank Direct Link, E-Claim connectors
• AI-7, AI-8 — RCM discharge-unsettled reconcile, e-Claim submission pipeline