Ghanaian facilities mix cash and NHIS on the same corridor. Flowrisehms treats insurance as a payer plugin, not the core.
The path
Patient, appointment, encounter, orders, then invoice. If the patient is covered, the claims desk builds an NHIA Claim-It v8.6 XML batch from that same visit. Feedback XML comes back in. The clerk does not maintain a parallel Excel.
What is honest
Catalog sync to NHIS is still a connector placeholder. Private insurer connectors are expanding. The Claim-It export and feedback import are live in the Insurance module.