A spreadsheet beside the accounts system
A patient buys a multi-cycle package, pays a deposit, and spreads the rest over instalments. They complete one cycle, pause, then return. Their partner's tests are billed separately. A medication item is excluded from the package. Six months later, the finance officer tries to work out what the patient has paid, what the package covers and what is owed. The answer lives across the accounts system, a card payment dashboard and a spreadsheet with a tab per patient.
Why package billing gets messy
- Accounts systems handle invoices and payments, not what a package includes and how much has been used.
- Instalments are taken through a card provider and reconciled by hand.
- Package usage depends on treatment progress, which finance learns about late.
- Exclusions and extras are recorded in notes.
- Balances are recalculated by hand when patients query them.
Pauses make it harder again. A patient who stops for a year and returns may be on an older price list or package version, and the terms that applied when they bought need to be the ones used. If the package is only described in a PDF and a spreadsheet, finding those terms is detective work.
What the mess costs
Finance spends time reconstructing balances. Patients receive inconsistent answers about what they owe. Refunds or credits under your package terms are calculated by hand, which is slow and error prone. And the clinic cannot see its outstanding package liabilities without a special exercise.
| Question | Spreadsheet answer | Package ledger answer |
|---|---|---|
| What did this patient buy? | Tab in the spreadsheet | Package record with terms |
| How much is used? | Updated when someone remembers | Updated from treatment events |
| What have they paid? | Accounts plus card dashboard | Reconciled payments in one place |
| What is due? | Calculated by hand | Shown with the instalment schedule |
How we build a package ledger
- We record each package type with what it includes and excludes, and the terms your clinic sets.
- When a patient buys a package, a ledger record is created and linked to their account in Xero, QuickBooks or Sage.
- Deposits and instalments taken through Stripe or your card provider are matched automatically, with exceptions queued for finance.
- Treatment events from your clinic management system update package usage, after a check by the coordinator.
- Patients can see a simple statement of their package, payments and what is due, if you want that.
- Finance gets a report of balances and outstanding package commitments across the clinic.
The ledger applies your terms consistently. It does not set them, and any refund or credit is approved by a person.
We also handle the awkward cases deliberately. Partners paying separate parts of a package, a relative paying on the patient's behalf, a finance provider paying the clinic directly: each is recorded as a payer on the package so receipts and statements go to the right person and the balance is still correct.
What finance gets
A single balance per patient that everyone trusts. Payments reconciled without hand matching. Quick answers to patient queries. A clear picture of package commitments for management.
Coordinators can answer basic balance questions without passing the call to finance, because the statement shows the same figures finance sees. Month-end is simpler because payments from the card provider are matched as they arrive, not in a batch at the end.
Could this help your finance team?
- Package balances are tracked in a spreadsheet.
- Card instalments are reconciled by hand.
- Patients query what they owe and answers vary.
- Package usage is updated late.
- Refunds and credits are calculated manually.