A rate that can vary
Per service, per doctor, per specialty. A single clinic-wide percentage is simple and fits almost nobody.
Blog
Doctor commissions without the monthly argument
Every clinic that pays commission has the same conversation at the end of every month, and it is almost never about the rate. It is about the figure the rate was applied to, which means it is about the record.
Invoiced or collected
The first decision, and the one most clinics never write down explicitly: is the commission on what was invoiced or on what was collected?
Invoiced is simpler and pays the doctor for money the clinic may not have. Collected is fairer to the clinic and introduces a lag the doctor feels. Both are defensible. What is not defensible is having never decided, which is how a clinic ends up applying one rule in good months and the other in bad ones.
Whichever you choose, the figure has to be traceable to the sessions that produced it. A commission line that cannot be opened to see what is inside it will be disputed, and the dispute will be unanswerable.
What makes the number stand up
Package revenue per session
Recognised as delivered, not on the deposit. Otherwise a doctor is paid in month one for work happening in month three.
Deductions with a reason
Lab costs, materials, advances — each against the case it belongs to, visible before the run closes rather than explained on payday.
A run that can be reopened but not rewritten
Corrections issued against the run they correct. Editing a closed month in place is how trust in the number disappears.
The conversation this replaces
When the commission line links to the sessions, the monthly meeting stops being an audit and becomes a review. The doctor can see which sessions, which services, which deductions, without anybody assembling a spreadsheet the night before.
That is worth more than the accuracy. A number nobody trusts costs the clinic a day a month and a slow erosion of goodwill; a number anybody can open costs neither.
Questions
Should commission be on invoiced or collected amounts?
Either, decided once and written into the contract. Collected is more common where insurance is a large share of revenue, because the lag between invoice and payment is long enough to matter.
How are insurance shares treated?
However the contract says — and the contract should say. The common approaches are commission on the full invoiced value or on the collected total including the payer share; both need stating.
What about work delivered by a covering doctor?
The session carries the clinician who delivered it, so the commission follows the work rather than the patient’s usual doctor.
Can a doctor see their own figures before payday?
They should be able to. Most disputes are timing rather than arithmetic, and visibility during the month removes them.
See it on your own clinic
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