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Billing, payouts and statements

Every report is a line
in somebody’s ledger.

Radiology software usually stops at the report and hands the money to a spreadsheet. This does not. A billing line is raised the moment a report is completed, invoices are built from those lines each month, and what a radiologist is owed comes out of the same records. The ledger and the worklist cannot disagree, because they are the same system.

On the live system
Invoices raised
791
Report lines on them
148,944
Hospitals invoiced
334
Billing periods
Monthly
Settled
509 of 846
Measured on 12 September 2026, covering May to August. Rounded where it matters.
791
Invoices raised
Monthly, May to August 2026
148,944
Report lines rolled into them
Out of 306,873 accrued
334
Hospitals invoiced
From one system
8
Statements, each date-ranged
With Excel and PDF exports

Where a charge comes from

Nobody keys in what to bill. The report does it.

The gap where radiology revenue leaks is between finishing a report and remembering to charge for it. Somebody exports a list at month end, somebody else reconciles it against the worklist, and the studies that fell between the two are simply never billed.

Here the charge is a consequence of the report rather than a separate task. Completing a report raises the line, and the database itself refuses a second automatic line for the same report, so a study cannot be double-billed by a retry, a re-open or two people working at once.

If it was reported, it is on the invoice. That is the whole point of keeping them in one system.

What a line carries
Raised when
The report is completed
Carries
Modality, procedure, images
Duplicate lines
Refused by the database
Added by hand
Marked manual, stays exempt
Price at that moment
None yet

Where the number comes from

We would rather show you a gap than a tidy wrong answer.

A line does not carry a price when it is created. The rate is resolved when the invoice is built, from the pricing group the procedure belongs to. That sounds like a detail and it is the difference between correcting one rate and hunting through months of already-stamped lines.

When a study has no rate configured, it is not quietly dropped and it is not guessed at. It is counted, and the running balance says so. The number on that screen is labelled indicative because it is honestly indicative, which is worth more at month end than a confident total that silently excluded the studies nobody had priced.

How pricing behaves
Rate applied
At invoice time
Rate corrected later
Fixes every unbilled line
Study with no rate
Counted and shown
Running balance
Labelled indicative
Assumed rates
Never

What the radiologist is owed

A statement nobody can quietly edit after it is issued.

Paying readers is where trust is won or lost, so the machinery is deliberately strict. A payout line accrues per report against whoever reported it. Where a study belongs to a group it splits into a line per member at that member’s share, and the system will not accept shares that do not add up.

A statement is a draft until somebody issues it, and a draft is invisible to the person it is about on every screen and every export, so nobody is shown a number that is still being worked out. Issuing assigns the statement number. After that the lines are locked, and a payment cannot be recorded against anything unissued.

Voiding reverses the payments and releases the lines back to be restated. That behaviour exists because the alternative was found the hard way: without it, lines stranded on a cancelled statement could be paid twice.

Being straight about maturity: the payout machinery is complete and the rate cards on our own platform are still being filled in, so we will show you how it works rather than quote you volumes.

The lifecycle
States
Draft, proposed, issued, void
Visible to the radiologist
Only once issued
Statement number
Assigned at issue
While a dispute is open
Cannot be accepted
Voiding
Reverses payment, frees the lines
Group studies split into one line per member at the agreed share, and the shares must total a hundred.

What you can pull out of it

Eight statements, three spreadsheets, five documents.

The statement view shows settled money only; the ledger view shows everything with its totals. They are separate screens on purpose, because the question 'what have we collected' and the question 'what is outstanding' are different questions.

Who can see which money

Ownership decides the ledger, and it is recorded rather than guessed.

Once one platform carries our own hospitals and partners running their own businesses, the hard question is whose money a given study represents. That is recorded explicitly on each site rather than worked out from circumstance.

It is worth saying why. An earlier version inferred it, and an audit of live data found the inference wrong for the overwhelming majority of sites. Inference was removed in favour of an ownership field, which is the sort of correction that only shows up when somebody checks real data against what the code believed.

The boundaries
A partner bills
Only their own sites
Our staff on a partner's site
Refused
A draft statement
Hidden from its payee
Whose line it is
Recorded, not inferred
Profit figures
We publish none

Straight answers

The questions finance people ask

Do we have to enter anything to bill a study?
No. A line is raised automatically when a report is completed, carrying the modality, the procedure and the image count. The database enforces one automatic line per report, so a study cannot be billed twice by accident. If somebody adds a line by hand it is marked as manual and stays exempt from that rule.
How is a rate applied?
At invoice time, from the pricing group the procedure belongs to, rather than being stamped onto the line when it was created. That means correcting a rate fixes every unbilled line that uses it instead of leaving you to hunt down the ones already priced wrongly.
What happens to a study you cannot price?
It is counted and shown to you as unpriced. The running balance is labelled indicative for exactly that reason. We would rather show you a number with a known gap than a tidy number that quietly assumed a rate.
How are radiologists paid for what they read?
A payout line accrues per report against the radiologist who reported it. Where a study belongs to a group, it splits into one line per member at that member's agreed share, and the shares have to total a hundred. A statement then moves through draft, proposed, issued and void, and nothing is visible to the radiologist until it is issued.
What if a radiologist disagrees with a statement?
There is a corrections channel, and an open correction blocks acceptance of the statement it belongs to. Payment cannot be recorded against anything that is not issued, and issued lines are locked. Voiding a statement reverses its payments and releases its lines rather than leaving them stranded.
Can a hospital or a partner see things they should not?
Invoicing is scoped to who owns the site. A partner running their own sites can bill those and only those, and our own staff are refused on a site that belongs to a partner. Draft statements are hidden from the person they are about on every screen and every export.
What can we get out of it?
Eight statements, each taking a date range and filterable to one hospital, radiologist or partner: two profit and loss views, commission, three party statements, revenue share and a live balance. Three Excel exports, and generated invoices, payout statements, money receipts and ledgers as PDFs.
Is this a general accounting package?
No, and we would not sell it as one. It is the money that comes out of radiology reporting, kept in the same system that produced the reports, so the ledger and the worklist can never disagree. Your accountant still has an accounting package.

Next step

Bring last month's numbers

Tell us how you bill today and what you pay readers. We will show you what the same month would look like coming out of the system that produced the reports.