How to Prevent Missed Billing: The Hidden Financial Toll of Missed Charges in Veterinary Clinics

Missed billing in veterinary clinics can be a silent revenue leak. Think of the times a busy vet forgets to charge for a dispensed medication, or a diagnostic test gets left off the invoice – each instance seems minor, but collectively they add up. Every unbilled service or product is income left on the table, income that could otherwise fuel staff development, new equipment, or enhanced patient care. Over months and years, these small leaks quietly erode a clinic’s revenue and make it harder to reinvest in what truly matters.

Small Misses, Big Losses: How Underbilling Adds Up

Even a single small missed charge each day can snowball into a significant loss over time. For example, imagine a £45 cytology test that isn’t invoiced once per day – that’s roughly £13,000 in revenue lost over a year. Now consider the myriad other charges that might slip through in a bustling practice: a follow-up exam that wasn’t billed, an injection fee overlooked, or a bag of prescription diet food given out but not recorded. These omissions are more common than you might think. Industry studies have found that around 17% of laboratory tests go unbilled, and that the average veterinary practice misses about 5–10% of all charges. Some audits have even discovered revenue leakage approaching 20% in certain clinics. Common culprits include small-ticket items like lab diagnostics, fecal exams, injection fees, or recheck consultations that easily slip through the cracks during a hectic day. It may not feel like much in the moment, but when as much as a tenth of your work isn’t being charged for, the cumulative impact is huge.

The Real Impact: What Lost Revenue Means for Your Clinic

Lost revenue from missed charges isn’t just a line on a financial report – it has real operational consequences. For a clinic grossing around £500,000 a year, an 8% leakage would amount to about £40,000 in lost income. In fact, one documented solo-doctor practice discovered it was missing roughly 8% of its gross revenue (around $40,000 per year) due to unbilled services – money that could’ve been spent on an additional staffing, a new ultrasound machine, continuing education, or staff raises.

In larger hospitals the stakes are even higher. A practice audit at a multi-doctor animal hospital revealed that depending on the veterinarian, between 5% and 20% of charges were not being invoiced – draining roughly $500,000 in revenue a year. Think what £500,000 could buy for your clinic! When profits shrink due to underbilling, it becomes much harder to justify new hires or equipment upgrades, the pressure to recover revenue through price increases mounts, and the whole team feels the strain of having to do more with less.

Beyond big investments, missed charges can affect day-to-day operations and staff morale. Undercharging means your practice is essentially providing care for free in those instances – the medications were dispensed, the lab tests run, and the staff’s time spent, but the clinic sees no reimbursement despite the pet owner presumably consenting to the procedure. This tightens cash flow and puts pressure on budgets. Over time, consistently slim margins may lead to postponed expansions, deferred equipment maintenance, or cutting back on continuing education opportunities for the team. In short, unnoticed billing mistakes quietly undermine your clinic’s ability to grow and to reward the hardworking people who make quality care possible.

Missed charge = missed reminder. Because most reminder systems are triggered by invoiced items, an unbilled service often disappears from the follow-up queue entirely. The pet owner never gets that nudge for a booster, lab recheck, or repeat parasite preventative, and the pet’s care schedule quietly unravels. In other words, underbilling isn’t just a revenue leak—it can cascade into gaps in adherence and poorer patient outcomes.

Why Do Missed Charges Happen?

If underbilling is so costly, why does it happen so frequently? The reality is that missed charges are usually unintentional byproducts of a busy practice, not willful giveaways. Veterinary professionals juggle many responsibilities in each consult – examining the patient, communicating with the client, formulating treatment plans, writing up medical notes, and more. It’s easy for a detail to be forgotten in the flurry, especially when moving swiftly from one appointment to the next. A doctor might perform cystocentesis, ear cleaning, or cytology during a consultation and plan to add it to the invoice later, only for that task to slip their mind amidst back-to-back cases.

Human error is at the core of most missed charges. Sometimes it’s a simple oversight or a breakdown in the hand-off between clinical staff and the front desk. In other cases, inconsistent record-keeping or relying on memory to enter charges at the end of a long day leads to items being omitted. Occasionally, well-intentioned staff might even skip charging for a service as a goodwill gesture to a client – but those small “freebies” add up and can set unsustainable expectations. More often than not, though, it’s the hectic pace and fragmented processes in a clinic that cause charges to fall through the cracks.

Recognizing that missed charges usually stem from workflow challenges (and not laziness or malice) is important. It means solutions should focus on making the process easier and more foolproof, rather than simply blaming staff for being busy. As one veterinary business article put it, teams are often astounded when a medical record audit reveals the deluge of charges that have been leaking unnoticed. The good news is that these leaks can be plugged with the right approach and tools – and doing so doesn’t have to add more work for your already busy team. Plugging the Leak: How AI Transcription Can Help

Catching every charge on every invoice might sound like a daunting goal, but modern technology is stepping up to make it achievable. Consult transcription tools – like PetsApp Scribe’s new billing assistant prompt – leverage artificial intelligence to ensure no billable item goes unnoticed in your records. They work by analyzing the transcribed consultation notes and automatically flagging anything that looks like a chargeable service, medication, or follow-up. In fact, industry experts recommend using voice-to-text transcription and smarter record-keeping systems as a key strategy to reduce missed charges. By digitizing the consultation conversation in real time, you create a complete, searchable transcript of what occurred during the visit. An AI-driven tool can then parse that transcript for keywords and context that indicate billable actions – essentially acting as a second set of eyes reviewing the consult. PetsApp’s billing assistant prompt is a simple but powerful example. It acts like a diligent virtual assistant that reads through the consultation transcript and produces a structured checklist of all the potential billable items mentioned. Critically, it organizes this checklist by category, mirroring how charges are typically grouped in a practice management system. For example, after a consult the AI might present:

Consultation Fee: Standard exam/consultation charge

Diagnostics: Skin cytology, blood test, X-ray imaging

Procedures/Treatments: Wound cleaning, dental scaling

Medications: Antibiotic injection administered, ear drops dispensed

Products: 5 kg prescription diet bag provided, e-collar (protective cone)

Follow-Up Recommendations: Recheck exam in 2 weeks, repeat bloodwork in 1 month

This structured prompt gives the veterinary team a clear, itemized rundown of what needs to be billed (or booked for follow-up). Instead of relying on memory or scribbled notes, you have an instant billing checklist generated straight from the consultation narrative. The vet or nurse can quickly review and confirm each item, greatly reducing the chance that something like a £45 cytology gets left off the invoice.

Importantly, these AI tools don’t require you to change how you consult. The beauty of a transcription-based billing assistant is that it works in the background, without altering your natural workflow in the exam room. Vets can converse with clients and focus on patient care as usual, confident that all the details are being captured. After the consult, the prompt’s checklist serves as a safety net – a gentle reminder of every service provided and recommendation made, neatly laid out for easy review. It’s like having a dedicated billing secretary listening to each appointment and taking notes for you, except it’s instantaneous and always available.

From Revenue Leakage to Financial Health: A Worthwhile Investment

By automatically capturing charges that would have otherwise been missed, tools like the billing assistant prompt help clinics recoup revenue they are rightfully earning. Over time, this can translate into tens of thousands in recovered income – funds that can go straight back into improving the practice. When revenue stops leaking, it can be redirected to where it belongs: upgrading an anesthesia machine, expanding the clinic’s pharmacy stock, giving your hardworking team a pay raise, or investing in new diagnostic tools. In essence, plugging these leaks strengthens the financial health of the practice, which benefits team members, clients, and patients alike.

Equally important, an AI-driven billing assistant reduces the mental load on the veterinary team. It provides peace of mind that nothing was forgotten, which is especially valuable during busy periods or when you have back-to-back consultations. It reinforces good billing habits effortlessly – acting as both a safety net and a training aid – so that over time, capturing all charges becomes the norm rather than the exception. The result is a more sustainable business where doctors and nurses can concentrate on medicine, not on double-checking invoices. Take Action: Capture More Revenue Without Changing How You Work

The consequences of missed charges are too significant to ignore, but fortunately the solution is now well within reach. Start by raising awareness among your team about the impact of underbilling, and encourage a culture of thorough charge capture. Beyond that, adopting a tool like PetsApp’s billing assistant prompt is a practical next step to ensure every service you provide is accounted for and billed.

Imagine the collective difference if your clinic stopped letting a chunk of revenue slip away every day. The added income could go toward that new ultrasound machine, or allow you to hire an extra pair of hands to support the team. Capturing this revenue doesn’t mean working more or increasing your fees – it’s about simply not overlooking what you’re already doing for patients. And with AI handling the heavy lifting of spotting billable items, you can achieve this without any disruption to how your vets and vet nurses consult.

It’s both an educational and a financial win. By leveraging consult transcription and intelligent prompts, you support your staff with better tools, provide more transparency on invoices for clients, and bolster your practice’s bottom line. Don’t let hard-earned revenue quietly leak away. Take the step to plug this gap: explore PetsApp Scribe’s billing assistant prompt and see how much more your clinic could be capturing. It’s a simple change that could reap many thousands in returns – empowering you to reinvest in your team, your equipment, and the exceptional care you provide.

About the Writer

Our very own Vet! Prior to PetsApp, Thom led innovative veterinary groups in the UK and abroad for years. He was the inaugural Chair of VetForum and advises companies looking to make a positive impact on society. Thom has a mini zoo at home with 4 kids, a dog and cat called Addy. Mountain gorillas are his second favourite animal at age 8 he set up a not-for-profit called The Gorilla Club.

Book recommendations:

The Goal by Eliyahu Goldratt

Business book in novel form. Super cheesy but also incredibly insightful = theory of constraints

Favourite podcast is Desert Islands Discs -  that plus a bath = good for my wellbeing

Poor Charlie's Almanack: The Wt and Wisdom of Charles T Munger also highly recommended.

Sources:

Sheridan, L. The opportunity = more revenue. The gap = missed charges. Covetrus (2023) – On average, hospitals failed to invoice 17% of diagnostic charges, and practices may be missing 10–20% of annual revenue due to missed fees.

EzyVet Blog. The foolproof way to reduce missed charges in your vet practice. (2022) – Estimates that 17% of lab tests go unbilled and 5–10% of charges are missed on average.

DVM360 Magazine. Don’t let charges escape (and why you should care). (2010) – One practice lost 8% of gross revenue (~$40k) to missed charges – money that could have gone to a technician’s salary, new ultrasound, or staff raises. Another hospital saw 5–20% of revenue (about $500k annually) slipping away depending on the doctor.

Malloy, J. Five silent revenue drains and ways to plug them. dvm360 (2024) – Recommends voice-to-text transcription to ensure all services are recorded for billing purposes.

Sheridan, L. The opportunity = more revenue. The gap = missed charges. Covetrus (2023) – Busy vets often simply forget to add performed services (e.g. an X-ray) to the invoice amidst a hectic day.