Free vs paid clinic software: the costs nobody quotes Messages, printers, GST, training and the cost of leaving, with a worksheet for any vendor.

The real cost of clinic software is the yearly total of everything it makes you pay for, in cash and in time, plus what it would cost to leave. For a 1 to 3 doctor OPD that means the subscription and any per-doctor or per-user fee, message charges for tokens and reminders, the printer and the computer at the desk, the internet line, GST on the invoice, the hours your staff spend learning it, and the work of exporting your records if you switch. A free plan can still carry most of these lines, and a paid plan can carry all of them, so the only fair comparison is the same worksheet filled in for each vendor.

If you are still deciding what the software should do, start with our page on clinic management software, which lists the modules a small OPD uses and a product-neutral checklist. This post is about money.

What does the price on the page actually cover?

A pricing page gives a number per month or per year. Before you compare two numbers, find out what unit each one is priced on, because the same clinic can look cheap on one model and expensive on another.

Write the answer in the vendor's own words in your notes. If a sales call says "unlimited" and the terms say otherwise, the terms win.

Who pays for WhatsApp and SMS messages?

Token updates, reminders and follow-up messages are where a low subscription can grow. On the WhatsApp side the rules are public. Meta's pricing page for the WhatsApp Business Platform, which says it reflects pricing updates effective 1 October 2026, states that Meta "charges on a per-message basis", "charges by category–market, and only for messages from businesses to users", and that businesses "are only charged when a message is delivered". The market is decided by the recipient's country calling code, and India is a named market on Meta's rate card.

• Meta lists three template categories: Marketing ("promotional objectives"), Utility ("transactional or informational objectives") and Authentication ("identity verification objectives"). A token or appointment update is the kind of message the Utility category describes; the category a vendor actually uses is set when its templates are approved, so ask.
• Replies that are not templates are Service messages. Meta gives each business phone number 1,000 free service messages a month and charges from the 1,001st.
• From 1 October 2026, Meta says utility templates sent inside an open customer service window changed from the free pricing type to "regular", which means they are charged.
• Meta asks eligible businesses billed in India to move their messaging accounts to rupee billing by 31 December 2026.

None of this tells you what your vendor charges you. The clinic usually does not deal with Meta directly; the software company does. So the questions for each vendor are: are WhatsApp and SMS messages included in the plan, is there a monthly cap, what is the price per message above it, and which events send a message (every token, every status change, or only the call to the cabin)? Multiply the per-message price by your daily footfall, the number of messages per visit and your working days. Our post on OPD token systems covers the opt-in rules that apply before you message patients at all.

What hardware and internet will you pay for?

Software that runs in a browser needs a computer at the desk, a printer and a connection. Most clinics already own some of this, so count only what you would buy or upgrade because of the new software.

• Desk computer or laptop: does the software run in a browser on what you have, or does it need a newer machine or an installed program?
• Doctor's screen: a tablet or second computer in the cabin if the doctor will type prescriptions.
• Printers: an A4 or A5 printer for prescriptions and receipts, and a small thermal printer if the software prints token slips. Count toner, ink and paper per month.
• Power backup: a UPS for the desk computer, printer and router, so a power cut does not stop billing.
• Internet: the main line, and a second carrier or phone hotspot as backup. If the software stops working without internet, the backup line is not optional; if it works offline, the backup matters less. Our post on what to do when the internet drops mid-OPD has a backup kit.

Can the clinic claim back GST on the software invoice?

Usually not, and that makes GST part of the cost. Consultation by a clinic or a registered doctor is exempt: Notification No. 12/2017-Central Tax (Rate), 28 June 2017, serial number 74, puts "health care services by a clinical establishment, an authorised medical practitioner or para-medics" at Nil. Section 23(1)(a) of the CGST Act, 2017 says a person "engaged exclusively in the business of supplying goods or services or both that are not liable to tax or wholly exempt from tax" is not liable to register. Section 16(1) gives input tax credit to "every registered person". So a clinic that only sees patients and is not registered cannot set the GST on a software bill against anything.

A clinic that is registered because it also makes taxable supplies is still limited. Section 17(2) restricts credit, where inputs are used for both taxable and exempt supplies, "to so much of the input tax as is attributable to the said taxable supplies". The part of the software used for exempt consultations does not earn credit.

What to do with this: when a quote says "plus GST", add the GST to the yearly figure before you compare, and ask the vendor what rate the invoice will carry. Your CA can confirm your position. Our post on GST on doctor consultation fees covers the exemption in detail.

How much staff time does a new system cost?

Time is the cost that never appears on an invoice. At most OPD desks the first fortnight on new software is slower than the paper parchi it replaces, because the receptionist is learning search, registration and billing while patients wait. Put it in rupees: hours spent in training and setup, multiplied by what that person costs the clinic per hour, plus any evening the doctor spends entering fees, favourites and templates.

• Is training included, and is it on a call, in person, or only videos?
• Who enters your fee schedule, doctor timings and letterhead: you or the vendor?
• Is there a setup or onboarding fee?
• Who answers when the desk is stuck at 10 AM on a Monday, and in which language?

When a receptionist leaves, part of this cost comes back with the next hire. A system the desk can learn in a day costs less over a year than one that needs a week. Our guide to training the front desk on new clinic software has a plan for the first week.

What does it cost to leave?

The cost of leaving is decided on the day you join. Your patient records are the clinic's records, and you are expected to keep them for years (our post on how long to keep medical records has the rules). If the only way to see them is inside one vendor's software, the clinic keeps paying that vendor or loses access to its own history.

1. Ask whether the clinic admin can export all data (patients, visits, prescriptions, bills) without asking the vendor.
2. Ask for the format. CSV or Excel files you can open are useful; a PDF of each visit is not a migration.
3. Ask whether export is in every plan, or only in a paid tier, and whether there is a fee for a full export.
4. Ask what happens to your data if you stop paying: read-only access, a grace period, or deletion, and on what date.
5. Run a test export in the trial, open the file, and check that a real visit is all there.

Our post on switching clinic software and moving your data walks through a move step by step.

What does a free plan cost if not money?

A free plan is paid for by someone. Before you sign up, find out who, by reading the terms and the privacy policy rather than the home page.

If a free plan is free because the vendor earns from your patients' data or your prescriptions, the cost falls on your patients and on your standing with them. The answer should be in writing.

The worksheet: one year, any vendor

Fill in one column per vendor. Use the vendor's written quote, your own footfall and your own staff costs. Leave a cell blank rather than guess, and ask the vendor to fill it.

Compare the totals and the non-money row together. A lower total with a "no" on export or data use is not the cheaper option over five years.