How much revenue does a veterinary practice lose every year without knowing it?

This article covers the French veterinary market; figures, prices and regulations are those of France.

Between 2% and 6% of a veterinary practice’s revenue evaporates every year in procedures that were performed but never invoiced, in untracked discounts and in silent data-entry errors. For a practice turning over €1.2 million, that represents €20,000 to €70,000 a year: the fully loaded salary of a vet nurse, or the depreciation of an ultrasound machine.

This figure is not a hunch. The AVMA estimates that unbilled procedures alone cut the income of American practices by 5% to 10%, and an audit published by Today’s Veterinary Business measured, in a multi-practitioner hospital, between 5% and 20% of missing lines depending on the vet. Veterinary groups have been tracking this gap for twenty years with dedicated indicators. Among French independents, almost nobody measures it.

Why is this question becoming urgent in 2026?

Because growth no longer covers the leaks. Footfall in French practices fell by 2% to 3% in 2025, as owners’ purchasing power deteriorated. At the same time, costs are rising: higher salaries to retain vet nurses, energy, consumables. The average basket is growing mostly through price increases, not through volume of procedures.

In concrete terms: when your procedures filled the diary and revenue grew 6% a year, losing 3% along the way went unnoticed. When volume falls and costs climb, those 3% make the difference between a decent year and a flat one. A French urban practice typically turns over between €400,000 and €600,000, more for larger structures. At €500,000, a 4% leak represents €20,000. It is your profit that walks out of the door, not your revenue: the margin on a procedure already performed is almost total, since the cost has already been incurred.

Where do revenue leaks in a practice come from?

The consultation that spills over into unrecorded procedures

This is the most ordinary leak. A vaccination consultation that turns into an ear infection: ear cleaning, swab, cytology done between two clients. The care is given, the patient record sometimes mentions it, the invoice never sees it. American studies point to the same recurring suspects: faecal tests, ultrasound-guided cystocentesis, blood draws, follow-up examinations. Everything that is done quickly, without going through the prep table, without a reflex code.

The front desk: parasite treatments and products handed over without going through the till

The owner leaves with a pipette “to tide them over”, a sachet of recovery food, a cone. The vet nurse is alone at reception, the phone is ringing, the product leaves the stock without an invoice line. A doubly costly leak: you lose the sale and you lose the stock trace, which throws off your inventories and your orders.

Untracked “mates’ rates”

The long-standing breeder, the colleague, the practice’s neighbour, the staff. Each discount taken in isolation can be defended. The problem lies elsewhere: when it is not recorded as a discount (line invoiced, then discounted), it vanishes from the statistics. You know neither how much you give away, nor to whom, nor whether practitioners apply the same policy. In some practices, unmanaged discounts alone exceed 2% of revenue.

Under-invoiced hospitalisation

The heaviest item in value. A dog hospitalised for 48 hours means dozens of potential lines: hospitalisation days, injections, IV fluids, dressings, monitoring, catheterisation. When invoicing is done from memory at discharge, lines are almost always missing. The AAHA measured that 17% of laboratory tests performed were not invoiced; for in-patients, the days themselves and injection fees are among the most frequent omissions.

What does a leak look like on the ground?

I still do locum shifts in practice. A few weeks ago, last consultation of a Friday, 18:50: a cat with a bite abscess. Debridement, flushing, injectable antibiotics, all between two calls about a dyspnoea on its way in. At the front desk, the owner worries about licking. The vet nurse grabs a cone from the display: “Here, take it, we’ll add it on.”

The dyspnoea arrived. We intubated, placed a line, called the on-duty vet. On the Monday, out of curiosity, I reopened the cat’s record: the invoice listed the consultation and the antibiotic. Neither the debridement nor the cone. About €45 gone, on a single record, a single evening. Nobody cheated, nobody did a bad job. Everybody treated. That is exactly how 3% of revenue evaporates: on ordinary evenings.

Why do groups measure it and independents don’t?

Veterinary groups (and American hospitals before them) have industrialised the question under one name: charge capture, the rate at which procedures are captured on invoices. They systematically compare what is written in the patient record with what is invoiced, per practitioner and per month. A variance above the threshold triggers a review. For a fund that values a practice at 5 to 10 times its EBITDA, every euro of leak plugged is worth €5 to €10 in valuation. So they have a direct financial reason to measure.

The independent, meanwhile, often has only their annual accounts. And the leak is invisible in the accounts: a procedure never invoiced leaves no accounting trace. Revenue looks “normal” because nobody ever saw what it should have been. The only way to see the leak is to cross-check the medical and the financial, which few tools and few habits allow today in independent practices.

How do you measure what your practice really loses?

The one-week audit: the simple method

Take a recent, normal week of activity. Pull 30 to 50 records, including consultations, surgeries and hospitalisations. For each record, reread the clinical report line by line and tick: does this procedure, this product, this injection appear on the invoice?

Three figures to extract:

1. The proportion of records with at least one missing line.
2. The average missing value per affected record.
3. The breakdown by category: procedures in consultation, products at the front desk, hospitalisation, untracked discounts.

Then extrapolate to the year: weekly missing value multiplied by your opening weeks. Allow 2 to 3 hours of work for 30 records. Most teams doing the exercise for the first time find between 3% and 8% of uncaptured value, with large variances between practitioners.

Continuous reconciliation of patient record and invoice

The one-off audit gives a snapshot. For lasting follow-up, you need systematic reconciliation: every procedure noted in the record must have its counterpart on the invoice, and every variance must be flagged. Manually, that is sustainable one week per quarter. Continuously, it requires software where the patient record feeds invoicing directly, rather than two separate entries.

How do you plug the leaks once identified?

Entry at the point of care, before leaving the room

The rule that changes the numbers most: every procedure is recorded where it is performed, when it is performed. Not “I’ll note it at the end of the day”. A practitioner’s memory at 19:00 is the worst invoicing tool in existence. Tablet in the consulting room, workstation in the ward, real-time entry by the vet nurse at the kennels: the means do not matter, the principle is the same.

The monthly variance review

Thirty minutes a month, on a fixed date. Three indicators: capture rate per practitioner, total discounts and their breakdown, average basket per consultation type. A tracked discount remains a legitimate management choice. An invisible discount is a leak. The review makes the subject factual and brings it out of the unspoken.

Raising team awareness, without blame

Present the audit figures at a team meeting, in annual euros. “We leave €28,000 a year on the table, that’s everyone’s end-of-year bonus, times four” speaks louder than a reminder about procedure. Set the frame: invoicing what is done is not overcharging the client, and the practitioner keeps the discretion to grant a discount, provided it is recorded as such.

Tools that make forgetting hard

The best process remains fallible if the tool imposes double entry. Look for specific functions: invoice generated from the patient record, alert on documented procedures with no invoice line, automatic stock decrement at dispensing, discounts that must be typed and tracked. These are the mechanisms behind the 15% of recovered revenue claimed by some American vendors after a switch.

FAQ

What rate of unbilled procedures is “normal”?

Aim for less than 2% of uncaptured value. Initial audits commonly show 5% to 10%. Below 2%, the effort of hunting costs more than it brings in.

Is invoicing every procedure overcharging clients?

No. It means invoicing the work actually done, at the displayed price. A goodwill gesture remains possible, but it becomes a deliberate, tracked discount, visible in your statistics.

How long does an invoicing audit take?

Allow 2 to 3 hours for 30 records reread by a vet and vet nurse working in pairs. Every other quarter is enough if your processes hold between two audits.

Who should own the subject in the practice?

A vet and vet nurse pair, not just the manager. Leaks are born in the consulting room and at the front desk. The people who work there are best placed to spot them and change habits.

Sources

• MSD Animal Health France, “Financial balance vs care: your challenge for 2026” (in French): 2% to 3% drop in footfall in 2025, cost inflation.
• Propulse by Crédit Agricole, market study of veterinary practices in France (in French): average revenue of urban and rural practices.
• KSM, “How Veterinary Practices Can Capture Missed Charges”: AVMA estimate of 5% to 10% of revenue lost to unbilled procedures.
• Today’s Veterinary Business, “Don’t Misfire on Missed Charges”: audit measuring 5% to 20% of missing lines depending on the practitioner, impact on valuation.
• dvm360, “Five silent revenue drains and ways to plug them”: typology of recurring leaks, AAHA data on unbilled tests.
• Shepherd Veterinary Software, “How to Get 15% Missed Revenue Back”: gains observed after automating the record-to-invoice link.

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Maxime Lachérade, veterinary surgeon (ENVA), co-founder of Treats.

Treats helps independent practices see what is really happening in their business.

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