# FAQs for finance URL: https://tymirahealth.com/resources/faqs/for/finance > 43 questions from finance, each with a short answer and a full answer page. ### [Can Tymira Health collect subscription fees for Tymira360?](https://tymirahealth.com/resources/faqs/can-tymira-health-collect-subscription-fees-for-tymira360) Tymira Health's finance workflows are planned to support subscription fee collection for Tymira360, alongside clinic-facing payment workflows where these are enabled. ### [Can a donor-funded clinic charge patients fees, and how is that income reported?](https://tymirahealth.com/resources/faqs/can-a-donor-funded-clinic-charge-patients-fees-and-how-is-that-income-reported) Check your grant agreement, because some funders prohibit user fees for funded services and others allow them but treat the money as programme income. ### [Can a patient pay through SHA and private insurance for the same treatment?](https://tymirahealth.com/resources/faqs/can-a-patient-pay-through-sha-and-private-insurance-for-the-same-treatment) Patients may hold private cover alongside SHA, and SHA's claim form asks whether the patient has another health insurer. ### [Can we ask SHA patients for a deposit before treatment?](https://tymirahealth.com/resources/faqs/can-we-ask-sha-patients-for-a-deposit-before-treatment) No, where eligibility and any required pre-authorisation are confirmed. ### [Can we charge an SHA patient more than the SHA tariff?](https://tymirahealth.com/resources/faqs/can-we-charge-an-sha-patient-more-than-the-sha-tariff) Only in limited cases. SHA's contract bans charging for anything within the benefit package, tariff and limits. ### [Do we charge VAT on therapy and counselling sessions?](https://tymirahealth.com/resources/faqs/do-we-charge-vat-on-therapy-and-counselling-sessions) Medical, dental and nursing services are listed as exempt supplies in the First Schedule to the VAT Act, so qualifying medical services carry no VAT, and related input VAT cannot be reclaimed. ### [Does our clinic need eTIMS if our medical services are VAT-exempt?](https://tymirahealth.com/resources/faqs/does-our-clinic-need-etims-if-our-medical-services-are-vat-exempt) Yes. KRA states that all persons in business must onboard eTIMS and issue electronic tax invoices, including businesses not registered for VAT, and it names hospitals supplying exempt medical... ### [How can therapy practices reduce revenue lost to no-shows and late cancellations?](https://tymirahealth.com/resources/faqs/how-can-therapy-practices-reduce-revenue-lost-to-no-shows-and-late-cancellations) Therapy practices reduce revenue lost to no-shows by sending automated reminders, taking deposits or card holds at booking, making rescheduling easy, applying a clear cancellation policy, filling... ### [How can we chase unpaid balances ethically and lawfully?](https://tymirahealth.com/resources/faqs/how-can-we-chase-unpaid-balances-ethically-and-lawfully) Send clear, factual reminders and offer a payment plan first. ### [How can we invoice employers for EAP or corporate counselling without revealing who attended?](https://tymirahealth.com/resources/faqs/how-can-we-invoice-employers-for-eap-or-corporate-counselling-without-revealing-who-attended) Invoice on aggregated, de-identified data: number of sessions or hours, service type, period and contract reference, not client names, staff numbers or reasons for attending. ### [How do insurance claims work for outpatient mental health in Kenya?](https://tymirahealth.com/resources/faqs/how-do-insurance-claims-work-for-outpatient-mental-health-in-kenya) In Kenya, outpatient mental health claims usually require the clinic to be on the insurer's or SHA's panel, confirm the member's cover and any pre-authorisation before the session, record services... ### [How do we match Paybill payments that arrive with wrong or missing account numbers?](https://tymirahealth.com/resources/faqs/how-do-we-match-paybill-payments-that-arrive-with-wrong-or-missing-account-numbers) Give each patient or invoice a unique account reference and print it on invoices and reminders. ### [How do we prepare for an SHA claims audit?](https://tymirahealth.com/resources/faqs/how-do-we-prepare-for-an-sha-claims-audit) SHA can inspect financial records with seven days' notice for routine audits and 24 hours' notice in fraud investigations, and can ask for claim support within seven days. ### [How do we refund a patient who paid by M-Pesa?](https://tymirahealth.com/resources/faqs/how-do-we-refund-a-patient-who-paid-by-m-pesa) M-Pesa has no simple refund button. On a Paybill, a full refund is usually done as a reversal from the M-Pesa organisation portal: a Business Web Operator initiates it and a Business Manager... ### [How do we run a sliding-scale fee policy fairly and defensibly?](https://tymirahealth.com/resources/faqs/how-do-we-run-a-sliding-scale-fee-policy-fairly-and-defensibly) Write it down: eligibility criteria, the fee bands, the evidence you accept, who approves, and how often you review. ### [How does Tymira360 support healthcare billing?](https://tymirahealth.com/resources/faqs/how-does-tymira-health-support-healthcare-billing-workflows) Tymira360 is designed to connect appointment activity, services delivered, patient payments and reporting. ### [How long do we have to submit an SHA claim, and when should SHA pay it?](https://tymirahealth.com/resources/faqs/how-long-do-we-have-to-submit-an-sha-claim-and-when-should-sha-pay-it) Under the current SHA provider contract, claims must be submitted electronically through SHA's Centralized Digital Platform within seven days of the date of service or discharge, whichever is later. ### [How long must we keep billing and financial records?](https://tymirahealth.com/resources/faqs/how-long-must-we-keep-billing-and-financial-records) The Tax Procedures Act requires tax-related records to be kept for five years from the end of the reporting period they relate to, or longer where an assessment or dispute is open. ### [How should a clinic reconcile M-Pesa, cash, card and insurance payments?](https://tymirahealth.com/resources/faqs/how-to-reconcile-clinic-payments-mpesa-cash-card-insurance) Reconcile every day. Match each attended appointment to an invoice, each invoice to a payment, insurer claim or approved waiver, and each payment to a line on your M-Pesa, bank or insurer statement. ### [How should a clinic set and account for no-show and late-cancellation fees?](https://tymirahealth.com/resources/faqs/how-should-a-clinic-set-and-account-for-no-show-and-late-cancellation-fees) Put the fee in a written financial policy that the client agrees to before the first session. ### [How should clinics communicate fees to patients?](https://tymirahealth.com/resources/faqs/how-should-fees-be-communicated-to-patients-and-providers) Clinics should explain fees clearly, in plain language and in local currency such as KES, before the patient pays. ### [How should mental health clinics in Africa price therapy sessions?](https://tymirahealth.com/resources/faqs/how-should-mental-health-clinics-in-africa-price-therapy-sessions) Mental health clinics in Africa should price sessions from the real cost of delivering care, including clinician time, premises, systems and admin, then compare with local market rates and what... ### [How should we account for prepaid session packages?](https://tymirahealth.com/resources/faqs/how-should-we-account-for-prepaid-session-packages) Money received for sessions not yet delivered is usually treated as a liability (deferred income or a contract liability) and recognised as revenue when each session is delivered. ### [How should we check insurance cover before a patient starts therapy?](https://tymirahealth.com/resources/faqs/how-should-we-check-insurance-cover-before-a-patient-starts-therapy) Before the first session, confirm with the insurer or the patient's scheme: whether outpatient mental health is covered, the annual limit or number of sessions, co-payments, which provider types are... ### [How should we price and bill teletherapy sessions?](https://tymirahealth.com/resources/faqs/how-should-we-price-and-bill-teletherapy-sessions) Price teletherapy on the clinician's time and costs, such as the platform, data and admin, and state clearly whether it costs the same as in-person sessions. ### [Is M-Pesa payment data sensitive when it comes from a mental health clinic?](https://tymirahealth.com/resources/faqs/is-m-pesa-payment-data-sensitive-when-it-comes-from-a-mental-health-clinic) Treat it as such. M-Pesa confirmations include the payer's phone number and name, which are personal data. ### [Is it acceptable for staff to collect payments on their personal M-Pesa numbers?](https://tymirahealth.com/resources/faqs/is-it-acceptable-for-staff-to-collect-payments-on-their-personal-m-pesa-numbers) It is a serious control risk. Payments to personal numbers bypass your records, make reconciliation and audit difficult, can mix clinic income with personal money and expose staff to suspicion. ### [Should billing staff be able to see clinical notes?](https://tymirahealth.com/resources/faqs/should-billing-staff-be-able-to-see-clinical-notes) Generally no. Billing staff usually need appointment dates, service codes, payer details and amounts, not session content. ### [Should corporate or insurer clients deduct withholding tax from our invoices?](https://tymirahealth.com/resources/faqs/should-corporate-or-insurer-clients-deduct-withholding-tax-from-our-invoices) Possibly. KRA lists management and professional fees among payments subject to withholding tax, at 5% for residents, and payers must remit within five working days. ### [What costs can an NGO charge to a donor-funded mental health programme?](https://tymirahealth.com/resources/faqs/what-costs-can-an-ngo-charge-to-a-donor-funded-mental-health-programme) This depends on the grant agreement, so read it first. Common principles across funders: costs must be necessary, reasonable, allocable to the programme, consistent with your own policies, incurred... ### [What documents must support an SHA claim?](https://tymirahealth.com/resources/faqs/what-documents-must-support-an-sha-claim) SHA's contract lists the beneficiary verification reference, any pre-authorisation reference, the itemised invoice coded to the tariff, and clinical records for the service line. ### [What does SHA pay facilities for mental health services?](https://tymirahealth.com/resources/faqs/what-does-sha-pay-facilities-for-mental-health-services) SHA's published tariffs show outpatient mental health counselling and psychosocial support funded within the primary healthcare outpatient package at Level 2, 3 and selected Level 4 facilities, paid... ### [What financial reports should a therapy practice run every month?](https://tymirahealth.com/resources/faqs/what-financial-reports-should-a-therapy-practice-run-every-month) Every month a therapy practice should review revenue by clinician and service, collections and outstanding balances, payer mix and claim status, no-show and cancellation losses, payment method... ### [What fraud controls should a clinic's billing and claims team have?](https://tymirahealth.com/resources/faqs/what-fraud-controls-should-a-clinic-s-billing-and-claims-team-have) Separate duties: different people should register patients, record services, submit claims and reconcile payments. ### [What should a corporate or EAP counselling contract say about pricing?](https://tymirahealth.com/resources/faqs/what-should-a-corporate-or-eap-counselling-contract-say-about-pricing) State the pricing model, such as a per-session rate, a monthly retainer per employee or a block of hours, plus what happens to unused sessions, the session cap per employee, and the rates for... ### [What should a patient payment plan agreement include?](https://tymirahealth.com/resources/faqs/what-should-a-patient-payment-plan-agreement-include) Include the total balance, the instalment amount and dates, the payment method and reference to use, what happens if a payment is missed, and how either party can change the plan. ### [What should we do if SHA pays less than we claimed, or overpays us?](https://tymirahealth.com/resources/faqs/what-should-we-do-if-sha-pays-less-than-we-claimed-or-overpays-us) Check each remittance advice promptly. Under the SHA contract, unless you raise a payment dispute within 14 days of receiving the remittance advice, that payment is treated as full and final for the... ### [What should we do when an SHA inpatient is close to their benefit limit?](https://tymirahealth.com/resources/faqs/what-should-we-do-when-an-sha-inpatient-is-close-to-their-benefit-limit) SHA's contract lists inpatient mental health care within an annual inpatient limit of 180 days. ### [When is SHA pre-authorisation needed, and how fast should SHA decide?](https://tymirahealth.com/resources/faqs/when-is-sha-pre-authorisation-needed-and-how-fast-should-sha-decide) SHA publishes the list of services needing pre-authorisation on its platform; for mental health, its tariffs state that admissions for drug and substance rehabilitation must be pre-authorised. ### [Which revenue metrics should a mental health clinic track by service line and site?](https://tymirahealth.com/resources/faqs/which-revenue-metrics-should-a-mental-health-clinic-track-by-service-line-and-site) Track gross charges and cash collected by service line, such as individual, group, psychiatry, EAP and teletherapy, and by site. ### [Who should we bill when a minor or a third party pays for therapy?](https://tymirahealth.com/resources/faqs/who-should-we-bill-when-a-minor-or-a-third-party-pays-for-therapy) Agree in writing at intake who is financially responsible, such as a parent, guardian, employer or sponsor, and invoice that person. ### [Why are SHA claims sent back or rejected, and how do we appeal?](https://tymirahealth.com/resources/faqs/why-are-sha-claims-sent-back-or-rejected-and-how-do-we-appeal) SHA may send back, reduce or reject claims priced above the tariff, charged to the wrong benefit, missing verification or pre-authorisation, poorly documented, or submitted late. ### [Will our business expenses be disallowed if suppliers do not give eTIMS invoices?](https://tymirahealth.com/resources/faqs/will-our-business-expenses-be-disallowed-if-suppliers-do-not-give-etims-invoices) They may be. Since 1 January 2024, KRA says business expenses not supported by a valid electronic tax invoice are not deductible for income tax, unless an exclusion applies. --- **About Tymira Health:** Tymira Health is a healthcare technology company based in Nairobi, Kenya. It builds Tymira360, a practice management and EHR platform for mental health, physiotherapy and dental providers, clinics, hospitals, NGOs and insurers across Africa. - Book a demo: https://tymirahealth.com/demo - Contact: https://tymirahealth.com/contact (info@tymirahealth.com) - All resources: https://tymirahealth.com/resources/all