Honorarios médicos — fee schedules, performance-based pay-out, audit-grade per fee paid.
Fee schedules per specialty, per payer, per contract type. Performance-based pay-out reconciled against episode volume and quality measures. Multi-entity practitioner rosters; payroll-adjacent settlement; audit-grade evidence per fee paid. The physician's economic relationship to the hospital, engineered into the back-office.
Fee schedules per specialty and payer
A specialist's fee for a procedure varies by specialty, by payer, by contract, by complexity tier. Each combination is a row in the engine's metadata repository, version-controlled and auditable. The schedule that applied on the day the procedure was performed is the schedule the audit shows.
Performance-based pay-out
Honorarios reconciled against episode volume and quality measures. Per-procedure fees, per-on-call shift compensation, per-clinical-target bonuses, per-quality-outcome bonuses — all calculated against episode data the engine already holds.
Multi-entity practitioner rosters
A specialist contracted across multiple hospitals in a group is one practitioner record with multi-entity contracts. Each hospital's payroll cycle settles independently; the group view rolls up automatically. Inter-entity referrals reconciled at the practitioner level.
Audit-grade evidence per fee paid
Every fee paid is linked to the clinical episode that triggered it, the contract clause that priced it, the payer adjudication that funded it, and the approval workflow that authorised it. The auditor's question answered with a single query — no spreadsheet reconciliation.
The physician's economic surface.
Five surfaces of the compensation engine, each a first-class concept. Specialty · payer · contract · performance · settlement.
Fee schedules at the metadata tier
Honorarios per specialty (cardiology · oncology · radiology · surgery · anaesthesia · etc.), per payer (private insurance per insurer, mutual societies, social security, state coverage), per contract type (in-house staff · external referral · capitated · per-episode · per-on-call), per complexity tier. Every combination is a row in the metadata repository — parameterised, version-controlled, the schedule audit-reconstructable for any historical date.
Performance-based components
Volume-based components (per-procedure fee × procedure count), quality components (target attainment for clinical KPIs), efficiency components (length-of-stay outliers, readmission rates, complication rates per the regulator's case-mix index). The performance metrics calculated from episode data the engine already holds — no separate analytics pipeline.
Multi-entity practitioner roster
A specialist working across a hospital group is one practitioner record with multiple entity-specific contracts. Compensation accrues per entity according to the contract for that entity. Inter-entity referrals (a specialist covering a procedure at sister hospital) tracked separately and reconciled at the group level.
Payroll-adjacent settlement
Physician fees are not payroll, but they integrate with payroll cadence — monthly settlement runs, withholding tax per the practitioner's tax regime, regulatory reporting against the social-security and labour authorities each market requires. The settlement file emitted in the format the hospital's payroll provider consumes.
Approval workflow with full audit
Every fee paid passes an approval workflow — the clinical-service head approves the procedure was performed, the finance department approves the contract terms applied, the payroll cycle approves the settlement. Each step recorded; the auditor's question (who approved this fee, when, against which contract, against which episode) answered as a single query.
Why physician compensation deserves a first-class module.
In most healthcare ERP implementations, physician compensation is a department that 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 on contract across multiple hospitals in the same group cannot easily see their cumulative position.
The hospital networks Axional Healthcare 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 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 too — through the practitioner portal, audit-grade, per episode, per fee, per payer adjudication.