A flat fee clinic software charges one fixed monthly price no matter how many patients you see, while commission software charges a percentage of every booking made through it. For most Indian clinics that see a steady patient load, the flat fee costs dramatically less over a year, because a commission quietly scales with your success while a flat fee stays still.
That difference is the single most important number in your software decision, and almost nobody calculates it before signing. This guide shows you how.
How does each pricing model actually work?
There are two ways clinic software companies charge you.
The commission model charges a percentage, often reported in the range of 10 to 20 percent, on consultations booked through the platform. You may also pay a subscription on top. The more patients book through it, the more you pay. Your busiest, most profitable month is also your most expensive.
The flat-fee model charges a fixed monthly subscription and takes nothing from your patient revenue. Medisray, for example, charges a flat monthly fee (Rs 999 or Rs 1,999) with 0 percent commission on any booking. Your busiest month and your quietest month cost exactly the same.
The models are not just different prices. They create different relationships. A commission vendor earns more when more patients flow through them, so their product is designed to keep patients booking through the platform. A flat-fee vendor earns the same regardless, so their only job is to keep the software good enough that you renew.
What does the one-year math look like?
Here is a simple worked comparison for a clinic seeing a moderate volume of platform bookings. Use your own numbers, but the shape holds.
| Item | Commission model | Flat-fee model (Medisray) |
| Monthly subscription | Often present, plus commission | Rs 999 to Rs 1,999 |
| Commission on bookings | A percentage of every consultation | Rs 0 |
| Cost in a busy month | Rises with patient volume | Unchanged |
| Cost in a quiet month | Falls, but the meter is always running | Unchanged |
| Predictability | Low, varies every month | High, same every month |
The pattern is clear. Under a commission model, the amount leaving your account is tied to how well you do. A doctor whose reputation brings in more patients ends up paying the platform more for patients the platform did not earn. Under a flat fee, your growth stays yours.
Why does the flat fee usually win for Indian clinics?
Three reasons a flat fee tends to cost less over a full year for a typical Indian solo or small clinic.
- Your patients are mostly yours already. Established doctors get the majority of patients through referral, reputation, and walk-ins. Paying a commission on those bookings is paying for introductions that already happened.
- Commission compounds. A small percentage feels harmless in month one. Multiplied across every booking, every month, for a full year, it becomes one of the larger line items in the clinic budget.
- Flat fees are predictable, and predictability has value. You can plan a clinic budget around Rs 999 or Rs 1,999 a month. You cannot easily plan around a number that moves with your patient count.
What should you check before you sign?
Before committing to any clinic software, ask the vendor these questions and get the answers in writing.
What exactly do you charge: a flat fee, a commission, or both? Ask for the total, not just the headline subscription. Does the commission or price change at renewal, and can you fix it in the contract? Are there separate charges for SMS credits, extra users, data export, or a “premium” tier? Can you export all your patient data any time without a fee?
Medisray publishes its pricing on one page, charges no commission, and includes the free clinic website, WhatsApp and SMS reminders, GST billing, and patient records in the flat fee, with full data export and no lock-in. That is the flat-fee model in its cleanest form.
How does the free clinic website change the math?
There is a second saving that the flat-fee model unlocks and the commission model usually cannot. A commission platform lists you on its marketplace, where new patients find you next to competing doctors, and takes a cut of the resulting booking. A flat-fee tool that includes a free website in your own name lets those new patients find and book you directly, with no cut taken at all.
That changes the comparison from “which model is cheaper for my existing patients” to “which model also helps me win new patients without a commission.” Medisray includes a professional clinic website in the flat fee, with the doctor’s name, photo, and booking form, so a patient who searches for the doctor lands on the doctor’s own page rather than a marketplace tile. Over a year, the bookings that come directly through that website carry zero commission, which widens the gap between the two models further in the flat fee’s favor. When you run your own twelve-month math, count the direct bookings the website can capture, not only the commission the flat fee avoids.
Frequently asked questions
What is flat-fee clinic software?
Flat-fee clinic software charges one fixed monthly or annual price for the software and does not take any percentage of your patient bookings or payments. Your cost stays the same regardless of how many patients you see.
Is commission-based clinic software ever cheaper?
Only for very low-volume clinics where the total commission in a year stays below a flat subscription. For most active clinics, the flat fee costs less over twelve months.
Does Medisray charge commission?
No. Medisray charges a flat monthly fee of Rs 999 or Rs 1,999 and takes zero commission on any booking, guaranteed in the contract.
How do I calculate my own commission cost?
Pull your last twelve months of platform statements, add up the commission column, and compare the total to twelve months of a flat subscription. The gap is your annual saving.
The bottom line
A flat fee and a commission look similar on a demo call and diverge sharply over a year. The flat fee keeps your growth yours; the commission takes a slice of every rupee your reputation earns. Run the twelve-month math on your own numbers before you sign, and you will usually find the flat fee is the cheaper and calmer choice.
See Medisray’s flat, zero-commission pricing, or book a demo to walk through your own numbers.