E-invoicing and the Health Card System for nutritionists: the simple guide
Team CibusAnyone working as a nutritionist or dietitian in Italy moves between two systems: e-invoicing (which goes through the Interchange System, SDI) and the Health Card System (STS), which collects citizens' healthcare expense data for the pre-filled tax return. They are two different channels, with different purposes and different rules. For the specific obligations in your case, your accountant remains the reference: the rules in this area are updated frequently.
SDI and the Health Card System: two channels, two purposes
E-invoicing (SDI) is the channel through which invoices travel to the tax authority. For a professional it typically concerns dealings with companies and other entities — consulting, teaching or collaborations.
The Health Card System (STS) is the channel dedicated to healthcare expenses: healthcare professionals transmit data on the services provided to patients, so that they find them in their pre-filled tax return. The patient can also object to the transmission of their data, and this choice must be respected and managed.
The key point: for healthcare services to individuals, the two channels don't work as they do for any other activity. The specific rules of the healthcare sector exist precisely to protect patients' health data.
Why managing it by hand is a risk
- 1Separate tools: the calendar on one side, invoices on another, transmission to the Health Card System on yet another. Every manual data transfer is a chance for error.
- 2Duplicate entries: the same patient data retyped two or three times, with the risk of typos on tax codes and amounts.
- 3Forgotten submissions: "I'll do it at the end of the month" is the phrase that precedes most late submissions.
- 4Untracked patient objection: when a patient objects to transmission to the Health Card System, you need a process that records and applies it — not a sticky note.
- 5Changing rules: the provisions on these topics are revised periodically; those who manage everything by hand also have to keep up to date on their own.
How Cibus simplifies it: SDI and Health Card System integrated
- The invoice is created directly from the appointment, with no duplicate entries;
- the patient's data is already correct because it comes from their record;
- the patient's objection to STS transmission is managed in the flow, not from memory;
- no separate invoicing software to pay for and reconcile.
The result is that the administrative side stops being a worry: you see patients, the rest flows.
Want to see how it works on a real case?
Leave your contact details and we'll get back to you to show you invoicing and the Health Card System integrated in practice.
Frequently asked questions
What's the difference between e-invoicing and the Health Card System?
E-invoicing (SDI) is the general channel for invoices to the tax authority; the Health Card System is the channel dedicated to healthcare expense data, which feeds patients' pre-filled tax returns. They are two distinct flows with distinct rules.
Does the nutritionist have to use both systems?
It depends on the type of services and clients (private patients, companies, collaborations). Your accountant frames your case; software that supports both channels covers you in every scenario.
What happens if the patient objects to submission to the Health Card System?
Their choice must be respected: the data for that service is not transmitted and the objection must be tracked. In Cibus this handling is part of the invoicing flow.
Do the rules on invoices and the Health Card System change often?
Yes, they are updated periodically. It's one of the reasons to rely on software that updates itself and on an accountant for specific obligations, instead of managing everything by hand.
Does Cibus support both SDI and the Health Card System?
Yes: e-invoicing and submission to the Health Card System are both integrated into the platform, connected to the calendar and the patient's record.