Malaysia is rolling out e-Invoicing in healthcare industry, and hospitals, clinics, and medical professionals need to know how it affects their billing processes. This guide breaks down the key changes in a simple and easy-to-understand way. 1. Will hospitals need to change how they issue invoices? Right now, hospitals issue invoices based on who is paying: Patients who pay for themselves Insurance companies, employers, or guardians paying on behalf of a patient Companies covering medical expenses for employees These billing arrangements will stay the same under e-Invoicing in healthcare industry. Exception: If the patient is a minor (under 18), the invoice should include the parent/guardian’s details. 2. Can hospitals issue one e-Invoice for all self-paying patients? Yes! If a patient does not need an e-Invoice, the hospital can issue a single consolidated e-Invoices for all similar transactions. 3. How does e-Invoicing work for insurance claims? Currently, hospitals send a proforma bill to insurance companies before getting a Final Guarantee Letter (FGL) and finalizing the bill. With e-Invoicing in Healthcare Industry: Hospitals can continue using proforma invoices for insurance claims. If an e-Invoice is requested, it must be issued after the final bill is ready (e.g., after the patient is discharged). If no e-Invoice is requested, hospitals can issue a normal bill and later submit a consolidated e-Invoices within 7 days after month-end. 4. How should hospitals issue e-Invoices for independent consultants? Hospitals work with independent consultants in two ways: (1) Co-Provision of Medical Services Both the hospital and consultant will issue separate e-Invoices to the patient. (2) Outsourcing Arrangement The hospital issues an e-Invoice to the patient, covering both hospital and consultant fees. The consultant (or their company) issues an e-Invoice to the hospital for their services. 5. Do locum doctors and nurses need to issue e-Invoices? It depends on how they are hired: If they are independent (contract for service), they must issue an e-Invoice to the hospital. If they work through an agency, the agency must issue the e-Invoice. If they are hospital employees, no e-Invoice is needed. 6. What happens when a patient is transferred between hospitals? Scenario 1: The first hospital discharges the patient before transfer. Both hospitals issue separate e-Invoices for their treatments. Scenario 2: The first hospital waits until the patient returns before issuing a bill. First hospital issues an e-Invoice for all services, including those from the second hospital. Second hospital issues an e-Invoice to the first hospital for its services. Both methods are acceptable under e-Invoicing rules. 7. Do hospitals need to issue e-Invoices for space rental & service fees? Yes! Hospitals must issue e-Invoices for: Rental fees charged to independent consultants Rental payments from cafes, convenience stores, or other tenants 8. Should hospitals submit summary or detailed bills for e-Invoicing? E-invoicing in healthcare particularly hospitals must issue e-Invoices based on the detailed bill (itemized breakdown of charges). 9. Do medical consultants need to implement e-Invoicing if the hospital is required to? Not necessarily. Even if a hospital’s revenue exceeds RM100 million, individual consultants only need to comply when their own revenue meets the threshold. 10. What about deposits collected by hospitals? Refundable deposit: No e-Invoice needed. Non-refundable deposit: E-Invoice required. For self-paying patients who don’t need an e-Invoice, hospitals can issue a consolidated e-Invoice. 11. How should hospitals handle e-Invoices for staff medical benefits? If the hospital already issues invoices for staff medical benefits: It must now issue an e-Invoice (with a nil amount if services are free). If no invoices are issued today: No need to start issuing e-Invoicing in healthcare for staff medical benefits. Conclusion The e-Invoicing in healthcare is designed to improve compliance, transparency, and efficiency in Malaysia’s healthcare industry. Most hospitals can keep their current billing process, but they must ensure e-Invoices are issued where required.