How diagnostic centres can calculate and track referral commission without disputes

In many diagnostic centres, the busiest day for the accounts team is not a weekday rush — it is the first week of the month, when referral commission is worked out.

Someone goes through a month of invoices, matches each to a referring doctor or agent, applies a rate from memory or a spreadsheet, adjusts for discounts and refunds, and writes a total. Then the phone calls start: “My patient came on the 12th — why isn’t she on my list?”

This guide explains how to calculate referral commission properly, the rules that prevent disputes, and how software turns a week of work into a report that is ready on the first of the month.

A note on compliance. Professional codes of conduct and regulations apply to payments involving doctors, and they change over time. Take advice on the current position, keep every payment transparent and documented, and follow your facility’s policy. This guide is about accurate, auditable record-keeping, whatever arrangements you have.

Why manual commission causes problems

• Missed referrals. The referrer wasn’t recorded at the counter, so the patient never appears on the list.
• Wrong rates. Different referrers, different tests, different rates — remembered rather than recorded.
• Discounts and refunds ignored. Commission is paid on the full price of an invoice that was discounted or partly refunded.
• Unpaid invoices included. Commission is paid on dues that were never collected.
• No evidence. When a referrer disputes the total, there is no line-by-line statement to show them.
• Time. Days of staff time every month, and a temptation to round numbers to make the problem go away.

Every one of these costs money or goodwill. Most are solved by a few clear rules and a system that applies them automatically.

The five rules of fair commission

1. Record the referrer at registration

The referrer — doctor, agent, collection centre or self — must be captured when the patient is registered or the invoice is created. Make it a required field. A searchable list of referrers prevents duplicates like “Dr. Rahman”, “Dr Rahman” and “Rahman sir”.

2. Set rates by rule, not memory

Write the rates down in the system, per referrer and per test or category. For example:

Category	Default rate	Referrer A	Referrer B
Routine pathology	20%	25%	20%
Hormone tests	15%	15%	10%
Ultrasound	Tk 200 fixed	Tk 250 fixed	Tk 200 fixed
CT / MRI	10%	10%	10%

Rates can be a percentage or a fixed amount per test. Some tests — like those outsourced to another lab — may carry no commission at all.

3. Calculate on money collected

Commission should be calculated on the net amount actually collected:

• After discounts. If a Tk 2,000 test was discounted to Tk 1,800, commission is on Tk 1,800.
• After refunds. If a test was cancelled and refunded, its commission is reversed.
• Only when paid. If the patient still owes Tk 500, commission waits until the due is collected.

4. Decide who carries the discount

When a referrer asks for a discount for their patient, many centres deduct it from that referrer’s commission rather than from the centre’s share. Whatever you decide, write it down and apply it the same way every time.

5. Give every referrer a statement

A monthly statement should list, line by line: date, patient, invoice number, tests, amount collected, rate and commission — then the total, previous balance and payment. When the statement comes from billing, disputes are usually settled by reading it.

A worked example

Referrer A sends three patients in a month:

Patient	Tests	Price	Discount	Collected	Rate	Commission
1	CBC, lipid profile	Tk 1,800	–	Tk 1,800	25%	Tk 450
2	Ultrasound whole abdomen	Tk 1,500	Tk 150	Tk 1,350	Tk 250 fixed	Tk 250
3	TSH, FT4	Tk 1,600	–	Tk 1,000 (Tk 600 due)	15%	Pending

Commission payable this month: Tk 700. Patient 3’s commission (Tk 240) moves to next month’s statement once the due is collected. Done by hand across hundreds of patients, this is where mistakes happen. Done by software, it is automatic.

How software does it

In Hospify Pro, commission is part of billing, not a separate spreadsheet:

1. The referrer is selected at the front desk when the invoice is created.
2. Rules are set once per referrer and per test or category — percentage or fixed.
3. Commission is calculated from collected invoices, after discounts and refunds.
4. Dues are tracked; commission is released when the money comes in.
5. Statements are generated for any period, per referrer, and can be printed or sent on WhatsApp.
6. Payments are recorded, so each referrer’s balance is always current.
7. Every change is in the audit log, so nobody can quietly alter a rate or an invoice.

The commission report that used to take a week is ready on the first day of the month. See billing, cashier and commission.

Controlling discounts at the same time

Commission and discounts are linked: uncontrolled discounts reduce both your revenue and the trust in your commission figures. Set discount limits per role, require approval above the limit, and review a discount report weekly. Hospify Pro does all three — more in our hospital software checklist.

Getting started

1. Clean up your referrer list — one entry per doctor or agent, with phone numbers.
2. Write down your rates per category, and any exceptions per referrer.
3. Agree your rules on discounts, refunds and dues — and tell your referrers.
4. Run one month in parallel — software and your current method — and compare.
5. Switch fully and send the first software statements.

Referral commission is included in every Hospify Pro plan. The full laboratory workflow with collection centres is in the Diagnostic plan at Tk 6,500 a month$149 a month, with a 14-day free trial.

• See Hospify Pro for diagnostic centres
• See the live demo — the real software with sample data, no sign-up
• Book a free demo