Where does the money leak? Automating the practice revenue cycle

Most practices look for growth in more patients. The faster win usually sits upstream: the invoice that went out late, the payment nobody matched to it, and the act that was typed three times before either of those happened.

Where the money leaks

The leak is not in patient volume. It is in the four places a figure gets re-entered by hand: the act at check-in, the invoice after the consultation, the payment when it is collected, and the reconciliation nobody has time to finish. Every re-entry is a chance to lose a line.

Deloitte's 2025 Global Health Care Outlook lists referrals, manual record entry, scheduling and confirmation calls among the back-office work still done by hand that could be automated with generative AI and other digital technologies. Source: Deloitte, "2025 Global Health Care Outlook", 2025.

We will not publish a figure for what late invoicing costs a practice, because the only honest one is yours. Time ten invoices end to end, multiply the average by a week's volume, and you have the number that decides whether any of this is worth buying. Apply the same test to every promise made in the name of practice management software in Tunisia: measure the task first, price the remedy second.

Entered once, at check-in

The act is entered at check-in. After the consultation the invoice is generated showing the patient share, the CNAM share and the CNAM code, and the bordereau is generated from that invoice. A bordereau is the summary form that carries a batch of acts to the caisse.

Conveyance of that file to the caisse remains with the practice. Doctopass constitutes the file up to the bordereau and stops there. We would rather write that limit down here than let it be discovered after signature.

The coding step inside that chain — matching an act to the insurance nomenclature — exists as AI CNAM auto-coding, and it is a Premium feature. It produces a draft: the code is proposed, the doctor reviews it and signs. There is no automatic finalisation and no silent write, in CNAM billing as anywhere else in the product.

Collection, and who does it

Collection is something the desk does. The practice takes payment by Stripe internationally, or Konnect and Flouci in Tunisia, in dinar. It records manual payments — cash, cheque, transfer, card, insurance — on all three plans, Essential included.

Those manual payments reconcile automatically against the invoice. Reconciliation is the matching of what was collected against what was invoiced, so that an invoice still open stops being invisible; without it, the only record of an unpaid consultation is somebody's memory of a Tuesday.

Two features are routinely mistaken for a dunning sequence, so it is worth naming them precisely. Appointment reminders, push and in-app on every plan, are about attendance. Post-visit care plans, a Pro and Premium feature, are clinical follow-up. Neither is an unpaid-invoice chaser and we do not present them as one; what tells you which invoices are still open is the reconciliation. The collection channels themselves are set out under online payment for clinics.

What each plan turns on

Invoicing and manual payments are on every plan. The automation is not: the invoice that writes itself from the consultation, the analytics that show where revenue stalls, and the coding that maps an act to the nomenclature each start higher up the range.

Audit log search and the investigation interface sit one step above that trail, on Premium. Feature pills elsewhere on this site name full audit logging without a plan qualifier; the comparison table is the gate, and where the two disagree the table is what you are buying.

Secretary seats are the other row that scales with the practice: one on Essential, three on Pro, five on Premium. That is the row deciding how many people can raise an invoice at the desk, which is why it belongs next to scoped secretary permissions rather than next to the AI features.

The arithmetic before the demo

Three sums, none of which needs a vendor. Invoices typed by hand in a week, times the minutes each one takes. Invoices still open at month end, times your average consultation fee. And the plan step you actually need, since auto-invoicing and revenue analytics both begin at Pro.

The costs that usually gather around a billing changeover are absent: no setup fees, no per-note charges, free data migration. Patients are free and unlimited on every plan, so patient volume never moves the bill. There are 14 days of free trial, which is long enough to run one real billing week rather than a demo dataset.

On the questions this article deliberately leaves open — what your accountant needs at period end, what your caisse expects in a file — put them to any vendor in the demo and watch the screen rather than the slide. A capability you have not seen executed on your own data is a capability you are taking on trust.

Frequently asked

Do my bordereaux leave for the caisse on their own?

No. The act is entered at check-in, the invoice is generated with the patient share, the CNAM share and the CNAM code, and the bordereau is generated from that invoice — conveyance of the file to the caisse stays with the practice. We would rather write that limit down than let it be discovered after signature.

Can my patients pay in dinar?

Yes. The practice takes payment by Stripe internationally, or by Konnect and Flouci in Tunisia, in dinar. Manual payments — cash, cheque, transfer, card, insurance — are recorded and reconciled automatically against the invoice on all three plans.

Where do I see what the practice actually earned?

In revenue analytics, and it starts at Pro. Essential raises invoices and records payments; the reporting layer sits one step up. Whether that layer alone justifies the step is a question to settle against your own month end.

What do the plans cost, and what does the step up buy in billing terms?

69 DT, 159 DT and 269 DT per doctor per month, billed annually. In billing terms, the step from Essential to Pro buys auto-invoicing from the consultation and revenue analytics; the step to Premium adds CNAM auto-coding and audit log search. Every row is laid out in the full plan comparison.

A practice does not have a revenue problem; it has a re-entry problem, and from the outside the two look identical. To watch an act entered at reception come back out as a split invoice, a reconciled payment and then a bordereau, request a 30-minute demo — bring a week of real invoices, paid and unpaid, it is the best test there is.