Centralizing e-Invoice Exchange and Auditing for 18 Public Healthcare Entities with Coopera
Organization
A regional public authority responsible for financial governance and procurement in the healthcare sector. With over two decades of operational excellence, this entity plays a strategic role in supporting financial optimization, digital modernization, and performance monitoring for hospitals and local health units across the region.
It manages centralized procurement of medical goods and services exceeding €800 million annually, while driving initiatives that improve transparency, accountability, and regulatory compliance across the healthcare network.
The Challenge
The initiative was launched following the 2015 introduction of Italy’s national e-invoicing framework (SDI), which made it mandatory for all public administrations to receive and manage electronic invoices through certified channels.
The regional authority aimed to support local healthcare entities in complying with this regulation by delivering a centralized, automated platform capable of:
- Receiving high volumes of e-invoices and interop messages from SDI in real time through different channels
- Automatically validating, accepting, or rejecting invoices
- Extracting metadata from each e-invoice and routing it to the appropriate internal department (e.g., finance, procurement, clinical administration)
- Achieving seamless integration with 18 different ERP and accounting systems
- Eliminating fragmented and manual workflows through automated and fully auditable processes
- Ensuring compliance with national invoicing and preservation laws, including legal archiving and metadata standards
- Providing real-time visibility into the full invoice lifecycle, with exception and SLA monitoring across the entire network
To ensure robust and certified interoperability with the national system, three official communication channels were implemented:
- Certified e-mail (PEC)
- Certified SOA-compliant web service
- Secure registered FTP exchange
The Solution
The authority implemented a regional digital platform powered by Coopera, leveraging its composable ECM and automation capabilities to unify document and invoice management and support end-to-end invoice processing across the healthcare network.
Key solution components included:
- Management of over 200,000 messages per month through different channels from national invoicing platforms
- Centralized acquisition, validation, and rejection of invoices in XML and PDF formats
- Intelligent metadata extraction and automated routing of invoices to internal departments based on content fields such as cost center, supplier, and service type
- Advanced Rules-Based Engine (RBE) to apply dynamic, customizable validation criteria and business rules, enabling precise invoice acceptance or rejection decisions without manual review
- Seamless integration with the regional ERP platform (SAP) and the accounting systems of 18 healthcare entities, including both hospital trusts and local health authorities through Coopera Hub Services
- Dynamic workflows for invoice lifecycle management, from reception to final delivery
- Full compliance with digital preservation laws, including PDF/A archival and traceability
- Isolated test and production environments to ensure operational resilience and regulatory conformity
Coopera Modules Involved
Coopera enabled the full digitization and regional centralization of fiscal document oversight, including electronic invoices, PEC messages, and regulatory validations—streamlining operations for 18 healthcare entities and ensuring full legal traceability.
- Document Management
Centralized archiving of XML and PDF invoices, PEC-certified messages, and validation outcomes across all regional entities.
- Email Management
Automated ingestion and parsing of PEC channels (over 200,000 messages/month), enabling validation, rejection, and legal compliance.
- Case Management
Aggregation of documents into structured digital folders (by invoice, provider, or healthcare unit), supporting full audit and reconciliation trails.
- Rules-Based Engine (RBE)
Application of customizable invoice validation rules, integrated with supplier data, fiscal codes, and regional compliance policies.
- Process Automation
End-to-end workflows for invoice reception, metadata enrichment, validation, approval, archival, and routing to finance systems.
- Dynamic Web Forms
Web-based tools for financial controllers and regional operators to annotate, flag, or correct invoices directly within structured workflows.
- Content Lifecycle Automation
Timed retention, lifecycle transitions, and compliance tagging for all documents, aligned with national preservation regulations.
- Coopera Integration HUB
Full interoperability with SAP and regional accounting systems, including automated delivery of validated flows to downstream systems.
- Content Analytics
Real-time visibility into invoice volumes, exceptions, SLA metrics, and entity-level performance analytics.
Benefits & Results
Coopera Platform transformed fragmented, manual invoice handling into a high-volume, fully digital platform used by all healthcare providers in the region. Coopera ensured real-time compliance, audit readiness, and full traceability—while offering secure, web-based access and performance dashboards for both local and regional oversight bodies.
- Over 10 million electronic invoices processed across the regional healthcare system
- More than 20 million fiscal documents securely archived with long-term traceability
- Significant reduction in manual effort and validation errors
- Complete compliance with national invoicing regulations and digital preservation standards
- Smooth interoperability with 18 healthcare entities, including hospital trusts and local health authorities
- Real-time monitoring of workflows, SLA metrics, and exception handling
- Recognized as a model of public-sector innovation and digital responsibility
