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.

1. 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-Invoice for all similar transactions.

2. 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:
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-Invoice within 7 days after month-end.

1. 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.

1. 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.

1. 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.

1. 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

1. Should hospitals submit summary or detailed bills for e-Invoicing?
   Hospitals must issue e-Invoices based on the detailed bill (itemized breakdown of charges).

2. 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.

3. 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.

4. 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-Invoices 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.