Physician compensation — fee schedules, production manager, audit-grade per fee paid.
Fee schedules per specialty, payer, contract type and complexity tier — version-controlled, reconstructable for any historical date. Performance-based pay-out with volume, quality and efficiency components. Production manager for episode-by-episode oversight. Automatic ERP synchronisation. Proven in production across hospital groups in Spain and Latin America.
Fee schedules at the metadata tier
Physician fees parameterised per specialty, payer, contract type and complexity tier. Every combination is a versioned row in the metadata repository. The schedule that applied on the day the procedure was performed is the schedule the audit shows — no reconstruction, no interpolation.
Production manager per episode
Episode status — performed, valued, blocked, temporarily blocked, permanently blocked — visible to the medical director across the full practitioner roster in real time. Adjustment vouchers generated automatically when post-episode movements change the production picture; each voucher is traceable to the originating episode.
Multi-entity practitioner roster
One practitioner record, multiple entity-specific contracts. Compensation accrues per entity per contract. Inter-entity referrals tracked separately and reconciled at group level. The group view requires no manual consolidation.
Automatic ERP synchronisation
Physician-fee vouchers synchronise into Axional ERP as supplier delivery notes. The accounting entry is automatic. Immediate or deferred invoicing per contract terms — the physician does not need to submit an invoice for the cycle to close.
The physician's economic surface.
Five first-class surfaces of the compensation engine. Specialty · payer · contract · production · settlement.
Fee schedules at the metadata tier
Physician fees per specialty — cardiology, oncology, radiology, surgery, anaesthesia and the full specialty catalogue — per payer (private insurers, mutual societies, social security, state coverage), per contract type (in-house staff, external referral, capitated, per-episode, per-on-call shift), and per complexity tier. Every combination is a parameterised row in the metadata repository: version-controlled, the applicable schedule reconstructable without exception for any historical date. A tariff update propagates to fee calculation, to the physician portal, and to the ERP synchronisation surface in a single operation.
Production manager — the medical director's surface
Episode-by-episode status across the full practitioner roster: performed, valued, blocked, temporarily blocked, permanently blocked. The medical director's operational surface — used daily, not monthly. When post-episode movements change the production picture — a procedure re-coded, a payer adjudication revised, an episode split — the engine generates adjustment vouchers automatically, positive or negative, each linked to the originating episode. An activity summary document per physician is produced at the cycle boundary: services rendered, amounts generated, discounts applied, final payable — in the format the physician reviews and the compliance officer signs off.
Performance-based components
Volume-based components (per-procedure fee multiplied by procedure count), quality components (target attainment against clinical KPIs), efficiency components (length-of-stay outliers, readmission rates and complication rates per the regulator's case-mix index). All three components calculated from episode data the engine already holds — no separate analytics pipeline, no data extraction to a reporting environment, no reconciliation against a downstream system.
Payroll-adjacent settlement and compliance
Monthly settlement cycles, withholding tax per each practitioner's tax regime — IRPF for Spain, fourth-category retenciones for Peru, retenciones en la fuente for Colombia. Settlement file emitted in the format the hospital's payroll provider consumes. Regulatory reporting to social-security and labour authorities per market. The payroll provider receives a file; the compliance officer receives an audit trail; neither requires a manual reconciliation step.
Approval workflow — audit-grade per fee paid
Three-stage approval: the clinical service head approves that the procedure was performed; the finance department approves the contract terms applied; the payroll cycle approves the settlement. Every step is recorded with user identity, timestamp, reason, contract clause and episode reference. The external auditor's question — who approved this fee, against which contract, against which episode — is answered as a single query against the engine's audit log.
Why physician compensation deserves a first-class module.
In most healthcare ERP implementations, physician compensation lives outside the system: a spreadsheet maintained by the medical director's office, reconciled monthly against the hospital's episode data by hand, settled through the payroll provider as a line-item. The reconciliation is fragile, the audit trail is thin, and a specialist contracted across multiple hospitals in the same group cannot easily see their cumulative position.
The hospital networks Axional Health Suite runs in production reject that arrangement. The specialist's contract is a structural concept; the episodes the specialist participated in are first-class data; the fee schedule that prices each episode lives in the same metadata repository as the rest of the financial engine. The settlement runs as a query against data the engine already holds — not as a reconciliation against a spreadsheet held outside the system. The production manager surface gives the medical director a real-time view of every specialist's episode pipeline, not a monthly snapshot.
The compensation engine is genuinely parameterised for market-specific regulatory regimes. IRPF withholding for Spain, fourth-category retenciones for Peru, retenciones en la fuente for Colombia, and national social-security contribution models in other markets all run on the same engine, configured as metadata — no separate implementation, no forked codebase. When a contribution rate changes or a tiered scale is revised, the team updates the metadata repository; the next settlement cycle reflects it.
The audit benefit is structural. The medical director, the finance director and the external auditor read the same numbers at the same time, derived from the same source. The specialist reads the same numbers — through the physician portal, audit-grade, per episode, per fee, per payer adjudication, in real time on mobile.