From booking confirmation to attended visit
How the Healthcare pack confirms an appointment, records whether the patient came, and settles the visit by invoice or at the till.
By Achekam · · 4 min read · For Healthcare businesses in South Africa, Nigeria, Kenya
Launching soon. The Industry CRM add-on described in this article is launching soon. This article describes it as it will work at launch.
An appointment looks like a single entry in a diary. In fact it is a small chain of events: the booking, a confirmation the patient can rely on, the patient walking in (or not), and the bill being settled before they leave. When any link breaks, the practice pays for it. A patient who never received a confirmation turns up on the wrong day. A visit that was never recorded as attended is never billed. A missed appointment nobody noted is never followed up.
The Healthcare & clinics pack in Achekam's Industry CRM treats each appointment as a record with its own workflow, so every link in the chain is a visible step rather than a habit.
Two records: the patient and the visit
The pack keeps two kinds of record. The Patient file holds who the patient is. The Appointment holds one visit. Keeping them apart means a patient can have many appointments over the years, each with its own history: when it was booked, whether it was confirmed, whether the patient came, and how it was paid.
The confirmation goes out first
Once a visit is booked, the appointment workflow sends the patient a booking confirmation. That one step removes a surprising amount of friction. The patient has the date and time in writing, and because the workflow sends it every time, it no longer depends on a receptionist remembering, which heads off most "nobody told me" conversations.
Make sure each patient's contact details are right at registration, because the confirmation can only reach the address on file. New patients are covered in registering a patient with signed consent.
Arrived, or missed
On the day, reception records attendance. Either the patient came, or they did not.
It sounds trivial, and in a busy waiting room it is the step most likely to be skipped. Yet it drives everything after it. An attended visit needs to be billed. A missed one needs a decision: do you rebook, phone the patient, or apply your missed-appointment policy? A practice that records attendance consistently can answer simple questions it otherwise guesses at, such as which patients miss visits repeatedly, or which days see the most no-shows. If no-shows turn out to be a real cost, a systematic review in BMC Health Services Research, Behavioural economic interventions to reduce health care appointment non-attendance, sets out the evidence on what cuts missed appointments, from reminders by SMS, phone or mail to other nudges, with their measured effects.
Late arrivals and walk-ins test the rule. A patient who arrives late but is seen has attended; record it that way and note the delay if it matters for your policy. A walk-in without a booking should be given an appointment record before they are seen, so their visit follows the same path to payment as everyone else's.
A short rule for reception: no appointment is left open at the end of the day. Every one is marked attended or missed before the front desk closes.
Settling the visit: an invoice, or paid at the till
After an attended visit, the workflow either invoices the visit or records that the patient paid at the till.
- Paid at the till. The patient pays at reception and leaves with a receipt. Achekam's till refuses a sale that is not paid in full, and its receipt is a PDF showing every payment, VAT by rate and the practice's tax number. The appointment simply notes that the visit was settled this way, so it is not billed twice.
- Invoiced. For a patient on account, or where part of the fee waits for a medical aid, the visit is invoiced instead. An invoice starts as a draft and, once issued, takes the next number and posts to the practice's books as an amount owed.
Which route applies is usually obvious at the desk. The point is that one of the two always happens, and the appointment shows which.
The tasks behind each step
Every stage of the workflow creates its own tasks, stage by stage, so reception sees only what is due now: confirm this booking, record this attendance, settle this visit. Tasks can carry subtasks up to three levels deep. That is useful for the visits that are not routine, for instance a procedure that needs a consent form signed, a room prepared and a follow-up booked, each as its own subtask under the visit.
Because the tasks belong to the appointment rather than to one receptionist's memory, cover is far easier on the day she is off sick.
What moves an appointment on
Some stages in the pack's pipelines cannot be entered until set conditions are met. Depending on the stage, that can mean a customer being named, an amount being set, a signature being done or an earlier workflow stage being complete. Conditions like these stop the shortcuts that cause trouble later, when a record has moved on but the thing it depended on never happened.
Here is one visit, end to end, in words. A patient books a check-up by phone; reception creates the appointment and the confirmation goes out. On the day the patient arrives, and reception marks the visit attended. The practitioner sees them and hands them back to the desk. The patient pays the consultation fee at the till and takes the receipt, and the appointment records that it was paid there. Nothing is left open, and the patient is ready for their next recall invitation when it falls due.
Where to start
Pick one week and hold the front desk to the end-of-day rule: every appointment confirmed, marked attended or missed, and settled one way or the other. The gaps that week reveals are the ones that cost you money. If staff are unsure what belongs on the appointment and what stays with the clinician, share what the Healthcare pack keeps with them first.
General guidance only, not advice on your own circumstances. Tax and payroll rules change: check the current position with the authority or your adviser.
