Compliance
Compliance Pitfalls in Electronic Invoicing & Copays in Colombia
Bogotá’s new rules clarify invoicing obligations for copays and the role of health system entities—avoid risking penalties by understanding the doctrine.
By NomadicTax Research Team • 5-8 min read • August 16, 2026
## What Changed: Copays, Cuotas Moderadoras & RIPS in Colombian Tax Law
In recent weeks, DIAN issued **Concepto Unificado No. 0106 de 2022**, with **adición del descriptor 1.1.11.4**, which clarifies:
- Copagos (copays) paid by users to access health services are **not** considered “anticipos” (prepayments) for tax purposes. They are **payments for services rendered** at the moment of provision, which trigger obligation to invoice. ([normograma.dian.gov.co](https://normograma.dian.gov.co/dian/compilacion/docs/oficio_dian_12008_2026.htm?utm_source=openai))
- If an EPS or payer entity pays part of the service, that portion should be documented separately and appropriately. Supporting documents like RIPS (Registro Individual de Prestación de Servicios de Salud) are **complementary**, but do not replace the need for the invoice of the health service. ([normograma.dian.gov.co](https://normograma.dian.gov.co/dian/compilacion/docs/oficio_dian_12008_2026.htm?utm_source=openai))
## Key Risks for Health Providers & Clinics
- **Failing to invoice** copays or the part of the service paid by the user can lead to denial of deductions for expenses, or disallowed credit for VAT (if applicable).
- Misclassifying user copay payments as prepayments or advances may lead to incorrect timing of revenue recognition and potentially under-reporting taxable incomes.
- Not issuing separate invoices when payer entities (EPS etc.) cover part of the cost can lead to missing supports required by tax authority in audits.
## Actionable Compliance Checklist
1. For every service provided in health sector having user copays, ensure either the service provider or collector issues an invoice covering the copay portion at the time service is rendered.
2. Keep RIPS or equivalent system entries consistent with invoicing—use them as complementary documentation but not as substitutes.
3. If part of the service cost is assumed by an EPS (or equivalent), issue separate invoice or document for that portion, with clear payer identified.
4. Ensure electronic invoicing systems are updated to include any sectoral technical annexes required (e.g. version for health-sector fields). The DIAN requires providers to follow UBL 2.1 standards and use the annex technical 1.8 with health-sector data. ([normograma.dian.gov.co](https://normograma.dian.gov.co/dian/compilacion/docs/oficio_dian_6046_2025.htm?utm_source=openai))
## Practical Example
A private clinic charges COP 200,000 for a consultation. The patient pays a copay of COP 20,000; the remaining COP 180,000 is to be paid by the EPS.
- The clinic must issue an invoice to the patient for COP 20,000 at the time of service.
- It must issue another invoice to the EPS (or payer) for COP 180,000, showing the payer name and legal entity.
- The electronic invoice to the EPS should include technical fields as per health sector annexes.
## Broader Implications & Enforcement
- These clarifications do not change rates or base taxes, but align obligations for documentation and invoicing—critical in audits.
- Health sector entities must adapt systems and administrative workflows to avoid penalties and ensure expenses and VAT credits remain valid.
## Final Thoughts
The clarification by DIAN ensures transparency and legal certainty in documenting health services. For clinics, hospitals, and EPS, proper invoicing of all components of service payments is not only good practice—it’s required. Upgrading invoice systems, training staff, and implementing sector-specific documentation are essential compliance moves now.