For many Spitex organizations, the last week of the month is the most stressful: chasing missing entries, reconciling hours, and assembling invoices under time pressure. A disciplined **month-end close** turns this scramble into a repeatable workflow with a defined sequence — review, lock, invoice, export, archive. This article walks through each stage of a modern, auditable billing close.
Stage One: Reviewing the Ledger
The close begins with a review of the month's **Care Ledger** — the complete record of delivered services. Care managers verify that every planned visit has a corresponding record, that recorded durations and care categories are plausible against the care plans and physician orders, and that exceptional events (missed visits, unplanned interventions) carry explanations. Because point-of-care documentation has been accumulating all month, this is a verification pass, not a data-entry marathon. The review surfaces gaps while the people who can close them still remember the visits in question.
Stage Two: Locking the Period
Once the review is complete, the billing period is **locked**. The lock is the pivotal governance moment of the close: from this point, the month's service records are immutable. No entry can be silently edited, backdated, or deleted; any correction after the lock must go through a documented adjustment in the following period. The lock protects the organization in both directions — it prevents accidental changes to billed data, and it gives auditors, insurers, and cantonal authorities a fixed, timestamped dataset to examine.
Stage Three: Generating Draft Invoices
With the period locked, invoice generation becomes a deterministic computation rather than a judgment call. The platform aggregates the locked records per patient and payer, applies the current tariff structures, computes the split between insurer contribution, cantonal residual financing, and patient participation, and produces **draft invoices** for review. Patient-facing invoices in Swiss francs carry the **Swiss QR-bill**, so payment details are machine-readable and reconciliation on the receivables side is automatic. Invoices must also satisfy the formal content requirements for outpatient care billing: under Swiss health insurance law (KVG Art. 42 and KLV Art. 7), a legally compliant Spitex invoice must explicitly detail the physician's prescription (ärztliche Anordnung with doctor GLN and prescription date), patient identifiers (AHV/NAVS13 number, insurance card number), care provider identification (ZSR and GLN numbers), exact dates and timestamps per intervention, and itemized billing according to KLV Art. 7 categories (a, b, and c) with the mandatory cost split between insurer, canton/municipality, and patient participation. The draft stage exists deliberately: a billing administrator confirms each invoice before anything is sent, keeping a human decision between the ledger and the letterbox.
Stage Four: Export and Distribution
Approved invoices leave the system in the formats their recipients require — electronic claims toward insurers, PDF invoices with QR-bills for patients, and structured **CSV or PDF exports** for accounting, municipalities, and internal controlling. Because every export is generated from the same locked dataset, the numbers in the accounting system, the insurer claim, and the patient invoice can never diverge.
Stage Five: The Audit Trail
The close ends with what remains afterwards: a complete, queryable audit trail. Who recorded which service, who reviewed and locked the period, which invoices were generated from which records, and what was exported when — every step is attributable. When a question arrives months later, whether from an insurer disputing a position or an auditor sampling a period, the answer is a lookup, not an archaeology project.
A locked, auditable month-end close is not bureaucracy — it is the mechanism that lets a care organization state its revenue with confidence. Teams that run this workflow monthly close faster every cycle, because the discipline compounds: clean point-of-care documentation makes review quick, quick review makes the lock timely, and a timely lock puts invoices in the mail while the month is still fresh.
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