Why We Don't Charge per Case

Your software bill should not move with your business

Most clinic systems bill per case. Per surgery, per treatment, per record. It sounds fair: you only pay for what you actually do.

We did it that way for two years. It does not work.

What per-case billing actually looks like

These are the real monthly figures from a surgical clinic on our platform — an ordinary practice, no outliers:

Same software. Same team. Same servers. The bill swings by a factor of seven.

In May this clinic pays CHF 1'600. In July, when half of Europe is on holiday, CHF 513. In September, after the summer, less again.

For us that is impossible to plan around. For the clinic it is worse: the bill peaks exactly when the clinic is busiest, and when things go quiet and the budget tightens, it pays less — but it has also earned less. The model amplifies the volatility a clinic already has to absorb instead of dampening it.

The real problem: the wrong incentive

There is a second reason, and it weighs more.

If every documented treatment costs CHF 1.50, you have created an incentive to document less. Not deliberately, not in bad faith — but the thought "does this really need its own entry?" gets thought once, and then it is there.

In an accounting system that would be a blemish. In a system holding anaesthesia protocols, controlled-substance records and signed consents, it is the opposite of what we want. A clinic should document because it is clinically and legally right, not weigh up whether the entry is worth the money.

A pricing model that taxes good clinical practice is a bad pricing model, however fair it looks on paper.

What we do instead

One flat price per clinic per month, with logins included.

No counting cases. No module fees. Document ten treatments or a thousand — the price is the same.

Who counts as a user

Only people who log in.

That is the second thing we changed. Per-seat pricing forces clinics to sort their own staff into categories: who is a "full" user, who is only "light"? In practice that collapses immediately. At our customers the nurse is also in administration, and the medical assistant helps out in theatre. People hold several roles, not one.

So we stopped asking. If you log in, you count — once, however many roles you hold. Anyone who only appears in the calendar, the OR plan, the roster or the working-time log without ever logging in costs nothing. Without limit.

That also solves a security problem in passing. When logins are expensive, teams share them. Then the audit trail carries the wrong name. In a system with controlled-substance records and signed documents, that is not a detail.

Clinic groups

Each location is billed according to its own size and the group receives a single invoice — with 10% off from 2 locations, 20% from 6 and 30% from 16.

What this costs us

Honestly: in some months we earn less.

That clinic's May would have brought us CHF 1'600 on the old model. On the new one it is CHF 449. Across a full year the two models land in roughly the same place for this clinic — but we give up the peaks, and in return we get something we value more highly: a number both sides know a year in advance.

And we stop giving our customers a reason to document less.

All tiers, group discounts and details: viali.app/pricing