See monthly what the Revenue Agency knows about your healthcare business.
FiscalPulse reads your Cassetto Fiscale monthly: doctors, contracts, suppliers, tax payments, letters.
€29 a month · no patient data · read-only, revocable
Sample company · illustrative data€46.41 billion
Italian household spending on private healthcare in 2024.
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That is 7.7% more than the year before. The invoices for these services to individuals do not pass through SDI, the national e-invoicing exchange.
Source: Ragioneria Generale dello Stato, healthcare spending monitoring on Tessera Sanitaria data (2025)
16.2 million members
Members of Italy’s 324 supplementary health funds in 2023.
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When a provider works under a direct agreement with a fund, it invoices the fund, and that e-invoice lands in the Cassetto Fiscale.
Source: Ministero della Salute, report on supplementary health funds (2023 data)
13 June 2025
D.Lgs. 81/2025 made the patient e-invoice ban permanent from this date.
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It covers e-invoices for healthcare services to individuals. Invoices to companies, funds and public bodies stay electronic.
Source: D.Lgs. 81/2025, art. 2 (amending art. 10-bis D.L. 119/2018); Euroconference News (2026)
What a provider finds every month
Who pays the revenue the Cassetto sees
Revenue split by payer, with each one’s weight.
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Payers are the ASL (the local health authority), funds under direct agreements, insurers and companies. The report tells you when one of them starts sending you less work.
Agenzia letters and F24, with dates
Agenzia letters reach you by email the same day.
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When a letter from the Agenzia delle Entrate (the Italian Revenue Agency) appears, the email brings a copy and the deadline. The month’s F24 tax payments, including withholding tax on doctors’ fees and staff contributions, are lined up before the 16th.
What each collaborating doctor costs
Doctors’ fees are spread across dozens of e-invoices.
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Self-employed doctors invoice the facility. The report adds them up by doctor and by month, and shows how much the top two or three weigh on total fees.
A report for the bank
A six-dimension tax score, updated to last month.
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It shows the regularity of tax payments, for a bank or leasing company.
Suppliers by category
Materials, labs and maintenance, against your peers.
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The comparison is with providers under the same ATECO code (the Italian activity classification), never supplier by supplier.
Non-medical staff cost
Rebuilt from F24 contributions.
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It is checked against the Certificazioni Uniche (CU, annual income statements) and Modello 770 (the annual withholding tax return).
Equipment leases
Lease instalments are spotted in the invoices.
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They sit with the month’s other outgoings.
The ISA score, where it applies
Practices see the Agenzia’s ISA score.
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For medical and dental practices this 1-to-10 tax reliability index shows the year it refers to, plus any compliance letters linked to it.
The fiscal credit score is a complementary tool based on declared tax data. It is not a regulated credit rating within the meaning of Regulation (EC) No 1060/2009.
Giulia shows what is inside and what reaches you every month.
The Cassetto sees almost every cost, and only part of revenue.
Services to individuals are invoiced on paper or as a PDF.
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The data goes to the Sistema Tessera Sanitaria, which feeds patients’ pre-filled tax returns. So those invoices never reach the provider’s Cassetto. What does reach it: invoices from collaborating doctors, laboratories and suppliers, and the e-invoices the provider issues to the ASL, funds, insurers and companies. Invoices to public bodies travel as FatturaPA, the e-invoice format required for the public sector. The report starts from there and always says what it cannot see.
- Doctors’ and professionals’ invoices
- E-invoices to the ASL and public bodies
- Invoices to funds, insurers, companies
- Suppliers, lease payments, utilities
- F24, staff contributions, CU and 770
- Agenzia letters and notices, ISA score
- Invoices and receipts to patients
- Front-desk payments, card and cash
- Appointments, treatments, medical records
- Bank balances and transactions
The providers we read, by ATECO code
- Private and accredited clinics and nursing homesATECO 86.10
- Outpatient and specialist centresATECO 86.22.03
- Imaging and laboratoriesATECO 86.91 (formerly 86.90)
- Dental practices and chainsATECO 86.23
- Physiotherapy and rehabilitation centresATECO 86.95 (formerly 86.90.21)
- General and specialist medical practicesATECO 86.21, 86.22.02
Getting started
Set up in about half an hour, then it runs on its own
- 01
You give us access to the Cassetto Fiscale.
The company’s Entratel or Fisconline credentials are enough: these are the logins an Italian company uses with the Agenzia delle Entrate.
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If you do not have them, we request them together through the company’s PEC, its certified email address, and they arrive in four to seven days. You can also appoint one of our partner accountants in Italy for read-only access.
- 02
We read the full history.
Invoices, F24 payments, LIPE, tax returns, letters from the Agenzia and credit registers: twenty-two document types, joined into a single reading.
- 03
You receive the report every month, in English.
A provisional version on the 3rd and the final one on the 18th, archived and ready to download.
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You also get an email every time the Agenzia writes to the company.
Your accountant in Italy keeps doing their job. If you like, they receive the report in copy.
€29 a month per Italian company, with the company’s own credentials
for companies with up to 2,000 invoices a year · cancel whenever you like
Cancel whenever you like, with no penalty. The yearly plan is paid in one instalment.
- Full monthly report, provisional on the 3rd and final on the 18th
- An email for every letter from the Agenzia, with the original attached and explained in English
- A reminder before every deadline
- Alerts on out-of-scale invoices and on customers who are buying less
- A version of the report to present to Italian banks and confidi (credit guarantee consortia)
- Archive of every past report, always available to download
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A hundred companies or more. Banks, leasing and factoring companies, credit guarantee consortia, networks and groups that follow at least a hundred Italian companies: we show you the engine in a demo on real positions from your portfolio.
An Italian company spends between €5,000 and €50,000 a year on its accountant, admin staff and software to produce the data that lands in the Cassetto Fiscale. For €29 a month, that data works for you too.
Questions
Does FiscalPulse read patient data?
No, it reads only the tax documents of the provider as a business. Healthcare invoices to individuals do not pass through SDI, so they are not in the Cassetto Fiscale. The report works on invoices to public bodies, funds and companies, supplier invoices, F24 payments, returns and letters from the Agenzia. Access is read-only and you can revoke it at any time.
What is in a clinic’s Cassetto Fiscale?
It holds the e-invoices issued to the ASL, funds, insurers and companies, and all those received from the provider’s doctors, laboratories and suppliers. It also holds F24 payments, returns, CU and letters from the Agenzia. FiscalPulse sums these documents up every month in one report, with emails giving amounts and deadlines.
Why are patient invoices not in the Cassetto Fiscale?
Because Italian law bans e-invoices for healthcare services to individuals. The ban began in 2019 to protect health data and became permanent with D.Lgs. 81/2025. That data goes to the Sistema Tessera Sanitaria. Invoices to companies, funds and public bodies remain electronic, and the report reads them.
Healthcare is VAT exempt: why read the F24?
Because a healthcare provider pays far more than VAT each month. The F24 form carries withholding tax on doctors’ fees, staff contributions, IRES and IRAP (corporate and regional taxes), and VAT on any taxable activities. The report lines them up with the amount before the 16th, next to any letters still open.
Does our accountant carry on as before?
Yes, the report adds to their work. If you wish, they receive it in copy every month, and when the Agenzia writes you both know the same day. You discuss the same numbers with the settlement deadlines already in view, and they keep handling returns, F24 payments and advice as before.
How much does the report cost?
It costs €29 a month, or €289 a year, for providers with up to 2,000 invoices a year. Setup takes half an hour with the provider’s Cassetto credentials, and you can cancel whenever you like. Above 2,000 invoices, write to us through the contact form; groups following a hundred providers or more get a dedicated demo.