What you have billed each ASL this year, and what each doctor costs you.
Every month FiscalPulse reads your clinic’s Cassetto Fiscale: ASL contracts, doctors’ fees, suppliers, staff, tax payments, letters.
€29 a month · no patient data · read-only, revocable
Sample company · illustrative dataThree facts for accredited clinics
The cap is a public-service duty
For the Corte dei conti, keeping within the spending cap is an accredited clinic’s duty.
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The Corte dei conti is Italy’s Court of Auditors. An accredited clinic, one authorised under accreditamento to treat patients for the regional health service, has a service relationship with that system, and the tetto di spesa is the spending cap the Region assigns. Over-budget services paid outside the procedures can become damage to public funds.
Source: Corte dei conti, Sez. I giurisdizionale centrale d’appello, judgment no. 233 of 15 October 2024
Above the cap, the receivable cannot be collected
The clinic cannot collect payment for services beyond a speciality’s cap.
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The tariff reduction (regressione tariffaria) also applies, even without the Region’s monitoring.
Source: Tribunale di Napoli, judgment no. 8834 of 17 October 2024
VAT on purchases stays a cost
Healthcare services are VAT exempt.
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The clinic therefore cannot recover the VAT it pays on equipment, supplies and maintenance. For the clinic it is a cost, and it weighs on the price of every investment.
Source: DPR 633/1972, art. 10, no. 18
The clinic read as a business
Letters, F24 and equipment leases
Equipment leases sit in different contracts.
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The report spots them in the invoices and lines them up with F24 tax payment deadlines and notices from the Agenzia, each with amount and date. When a letter from the Agenzia delle Entrate (the Italian Revenue Agency) appears, it emails you the same day with the copy attached.
What each collaborating doctor costs
Doctors’ real cost is scattered across dozens of invoices.
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Self-employed doctors invoice the clinic, and the report adds those invoices up by doctor and by month and shows how much the top two or three weigh on total fees. You see in time how much you depend on each one.
Billing to each ASL, next to the cap
Cap overruns are often discovered only at year end.
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The cap per speciality comes with a regional resolution, and the report reads the e-invoices the clinic issues to the ASL (local health authority), sent as FatturaPA, the public-sector e-invoice format, and shows year-to-date billing per body every month. Put it next to the assigned cap and you see how much room is left for the remaining months.
For a lease or a credit line
Every month you have a version for the bank or leasing company.
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It carries the tax score on six dimensions and the regularity of tax payments.
Simulating the next investment
Lease payment, break-even services and cash left after the instalment.
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VAT is treated as a cost, and existing leases are already counted.
Suppliers by category
Materials, outside laboratories, maintenance and services, compared with peers.
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The comparison uses facilities under the same ATECO code (the Italian activity classification), never supplier by supplier.
Non-medical staff, without estimates
The cost comes from F24 contributions, checked against the CU and the Modello 770.
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The Certificazioni Uniche (CU) are annual income statements and the Modello 770 is the annual withholding tax return.
How much you depend on one payer
Each payer’s share and the concentration index.
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Payers are the ASL, funds under direct agreements, insurers and companies. If a fund sends you less work, you get an email.
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 cap is annual, ASL invoices are monthly
The Region sets a budget per speciality, and the clinic invoices the ASL monthly.
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Budgets often come through three-year resolutions. Services above the cap are still delivered, but the receivable cannot be enforced and at year end the tariff reduction may apply. The data to notice it in time already exists: the e-invoices the clinic has issued. The report adds them up per body every month, and each edition is archived exactly as it was generated.
The clinics we read
- Nursing homes and private hospitalsATECO 86.10
- Clinics accredited with the regional health serviceATECO 86.10
- Day surgery centres and specialist clinicsATECO 86.10, 86.22.03
- Residential facilities with nursing careATECO 87.10
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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Questions
Does FiscalPulse read patient data?
No, it reads only the clinic’s tax documents as a business. These are invoices with the ASL, funds, insurers, companies and suppliers, F24 payments, returns and letters from the Agenzia. Healthcare invoices to individuals do not pass through SDI, the national e-invoicing exchange, under D.Lgs. 81/2025, and the report does not see them. Access is read-only and revocable at any time.
Does the report see invoices to the ASL?
Yes, because the clinic issues e-invoices to the ASL and they land in the Cassetto Fiscale. Every month the report adds up billing per body from the start of the year. You know the cap from the resolution: put the two numbers side by side and you see how much room is left before the threshold.
How do self-employed doctors’ fees show up?
They show up as invoices received, one per doctor and period. The report adds them up by doctor and by month and calculates how much the top doctors weigh on total fees. The withholding tax paid on those fees appears in the month’s F24 payments, with the clinic’s other tax payments.
Healthcare is VAT exempt: does the report account for it?
Yes. For a clinic, Italian VAT paid on purchases and investments is largely a cost, and the report treats it that way, both in the facility’s costs and in the simulation of new equipment. If the clinic also has taxable activities, VAT deadlines stay in the schedule with the other F24 payments.
Does it calculate non-medical staff cost?
Yes, it rebuilds it from the contributions paid with F24 and checks it against two independent sources, the CU and the Modello 770. The cost of nurses, technicians and administrative staff stops being an estimate and can be compared with revenue month by month.
Can I use it to apply for equipment leasing?
Yes. Every month you have a version to present to the bank or leasing company, with the tax score on six dimensions, the regularity of tax payments and figures updated to the previous month. You arrive at the application with the clinic’s numbers already explained.