The situation
A three-vet small animal clinic in Germany had operated at the same revenue level for two consecutive years. Costs had risen — staff, consumables, software — but turnover had not kept pace. The owner had considered raising prices but was reluctant: the clinic served a mixed urban-suburban population, and they feared losing patients to a larger practice nearby.
They joined the Smartemis network in early 2023. Within the first month, the Smartemis practice development team carried out a full billing and PMS audit.
What the audit found
The audit identified three distinct sources of under-billing, none of which required any change to treatment protocols or pricing:
- Incomplete consultation itemisation. The PMS was configured to bundle certain procedures that should have been billed separately. Around 14% of consultations were affected.
- Missed post-visit follow-up billing. Phone calls and email follow-ups were being absorbed into consultation fees rather than billed as separate items, as permitted under standard veterinary billing guidelines.
- Medication dispensing records. A mismatch between dispensed quantities and billing records indicated that approximately 8% of medication revenue was not being captured.
None of these were errors — they were configuration and workflow gaps that had accumulated over time and gone unnoticed because the clinic had no external reference point for what correct billing looked like.
"I assumed our billing was fine because nobody had ever told us it wasn't. The audit was eye-opening — not because anything was wrong, but because we'd been leaving money on the table for years without knowing it."
What changed
The Smartemis team worked with the clinic's practice manager over six weeks to reconfigure the PMS, update billing templates, and introduce a short weekly reconciliation check. No new software was purchased. No prices were raised. No additional appointments were needed.
The changes took effect in stages. The billing reconfiguration was live by week three. The follow-up billing workflow was adopted by week five. By the end of month two, the clinic had a clear picture of the revenue impact.
Year 1
to first results
required
Why this matters for the network
This story is not unusual. The Smartemis practice development team has carried out billing audits across multiple network clinics and found under-billing in the majority of cases — not through negligence, but because independent clinic owners rarely have a reference point for what optimized billing looks like.
The network effect is significant here: the benchmarks that identify under-billing in one clinic are built from data across all clinics. A single-practice owner cannot access that comparison. A 125+-clinic network can.
The 18% revenue increase in this case was achieved entirely through better capture of value that was already being delivered. No price increases. No additional patients. No new equipment. Just accurate billing for work already done.
"The network doesn't just give you access to services — it gives you access to a benchmark. You find out what 'normal' looks like, and you realize you've been operating below it."