Contracts and insurance pricing
Manage negotiated pricing for companies, hospitals, doctors, insurers, and partner labs.
What contracts manage
A contract is a payer your lab works with: an insurer, hospital, company, doctor, or other organization. It holds the payer's details and how much of each invoice the payer covers.
The prices the payer pays come from a price list linked to the contract. When reception selects the contract on an order, Kashef prices the order from that list automatically. See Prices and price lists.
Contract details
Enter the contract type, the payer name in English and Arabic, a short code, the Default Coverage, and whether the contract is active. The table shows the payer, type, coverage, status, and last update.
Use a clear name and code so finance and reception recognize the agreement without opening it.
Contact information
The contact section includes contact name, phone, email, and notes. Use it for contract account managers, authorization contacts, billing contacts, or escalation details.
Do not store sensitive patient claim details in contract notes. Use patient or insurance records where appropriate.
Prices and coverage
Default Coverage is the share of each invoice the payer covers. The patient pays the rest. For example, with 80% coverage the payer is billed 80% and the patient pays 20%.
To give the payer lower or higher prices, create a price list for it and link this contract. Use the list rule for a discount on every item, and special prices for items with an agreed amount.
Active status
Deactivate a contract when it should no longer be used for new orders. Existing orders may still reference it historically. Do not delete old contracts unless your data policy allows it and reports will not be affected.
Operational checks
Before making a contract available, create a test order using that contract and confirm price, coverage, patient balance, invoice behavior, and cashier workflow. Train reception on which contract to select and what documents are required from the patient.