Packages, Memberships and Credits: Running Courses of Treatment Without a Spreadsheet

Somewhere in most clinics there is a spreadsheet with a tab per patient on a course of treatment, a column of dates and a running count that is right until somebody is off sick. It exists because the clinic's software models appointments and invoices but not the thing in between: the course of six the patient paid for in March and is four sessions into. Reviews of established platforms list missing packages and memberships among the reasons clinics look elsewhere, and practice management software that models all three properly is what retires the spreadsheet.

This post sets out the three objects, the five rules each needs, what reception and the owner must see, and how to move the balances across.

Three objects, not one

A package is a fixed set of sessions bought together: a course of six laser sessions, a block of ten physio appointments, a bundle of three consultations and a review. It has a start, a count and an end.

A membership is a recurring arrangement that renews on a date and includes an allowance each period: two facials a month, unlimited classes, a quarterly review. It has a renewal date, an allowance that resets, and a question about what happens to an unused allowance.

Credits are a balance the patient draws down against any eligible service, often bought as a gift or as a prepayment. They have a balance, an expiry and a list of what they can be spent on.

A spreadsheet treats all three as a count. Software has to treat them as three objects, because the rules below differ for each.

The five rules every one needs

Write these down before selling the first course, and make the software apply them.

1. What it contains. Which services, which practitioners, which locations. A course of six at one practitioner's rate, usable with any practitioner, is a decision, not a default.
2. When it expires. Twelve months from purchase, six months from first use, the end of the membership period. Expiry is what stops the five-year-old course appearing at checkout.
3. Who can use it. The purchaser only, or a family; one location or all.
4. What happens to the unused part. Lapse at expiry, extend on request, transfer to another service, refund the balance. Reviews are full of disputes that come from this rule never having been written.
5. What the patient sees. Remaining count, expiry, renewal date, in the portal and on the receipt.

The rules can differ per package. They cannot be absent.

What reception must see

Two moments matter, and the software has to put the balance in front of reception at both.

At booking. When a patient on a course books, the diary shows the course, the remaining sessions, the expiry and whether the chosen service and practitioner are covered. A booking that would exceed the course or fall outside it is flagged then, not at checkout.

At checkout. The session is deducted from the course, the receipt shows the new balance, and no invoice is raised for a session already paid for. The two mistakes a spreadsheet produces, invoicing twice and forgetting to deduct, both disappear when the deduction is part of checkout.

For memberships, the same two moments plus a third: renewal. The renewal date is visible, a failed renewal is flagged to reception before the patient's next visit, and a lapsed membership stops covering sessions rather than quietly continuing.

What the owner must see

One number above all: sessions sold but not yet delivered, per package type and in total. It is the clinic's obligation to its patients, the figure the accountant asks for at year end, and the number a spreadsheet gets wrong most often. Beside it: courses expiring in the next month that still have sessions left, which is a list for reception to call; memberships due to renew; and completion rate per package type, because a course of six that is routinely abandoned at four is telling you something about the course.

What the patient sees

The portal shows the course or membership, the remaining count, the expiry and the next renewal date, and the receipt after each session shows the new balance. That removes the most common phone call to reception ("how many have I got left?") and the most common dispute at checkout. A reminder for a course session can carry the count too: "Session four of six".

Refunds, transfers and exceptions

Rule four will be tested, and the software has to let reception apply it without a spreadsheet and without a workaround. A refund of the unused part is a credit note against the original sale and a closed course. A transfer moves the balance to another service or person with a note. An extension changes the expiry with a reason. Each is recorded against the course, with who did it and when, so the owner can see exceptions as a list rather than discover them.

Moving off the spreadsheet

The migration is one afternoon, if it is done once and properly.

1. Close the sheet at a date. Nothing is recorded in it after.
2. Export it as one row per patient per course: package type, purchase date, sessions bought, sessions used, expiry.
3. Import the balances into the platform as open courses with their remaining counts.
4. Check with the clinic. Reception reviews the imported list against their memory; the dozen they correct are the dozen the sheet had wrong.
5. Switch checkout to deduct from the day after, and retire the sheet.

Patients see their balance in the portal the same week, which is usually when the first correction request arrives, and that is the system working.

Designing a package that gets completed

A course that is routinely abandoned at session four is a design problem, and the design is in the clinic's hands. Three habits help. Book the whole course at purchase, so the six sessions sit in the diary from day one rather than being booked one at a time by a patient who has to remember. Set a cadence that matches the treatment, with the reminder for each session carrying the count, "session three of six", so the patient sees progress and the end. And agree the expiry with the cadence in mind: a course meant to run over twelve weeks with a six-month expiry gives room for a holiday without giving room to drift.

The completion rate per package type then becomes a number the owner can act on: a course completed by most patients is working; one completed by half is either too long, priced for a different patient, or being sold to people who wanted a single session.

Memberships: three decisions

A membership needs three decisions written down before the first one is sold, and the software needs to apply them. Rollover: does an unused allowance carry into the next period, in full, in part or not at all? Pause: can a member suspend for a month, and does the expiry move with it? Notice: how much notice does a member give to end the arrangement, and what happens to the current period's allowance when they do? Every one of these will be asked at reception in the first month, and an answer invented on the spot becomes a precedent. Decide, record, and let the system say the same thing to everyone.

How Capra models them

Packages, memberships and credits as separate objects with their own rules for contents, expiry, use, unused balance and visibility; the balance shown to reception at booking and deducted at checkout; renewals tracked with failures flagged; refunds, transfers and extensions recorded against the course; sessions sold but not delivered reported for the owner; and the patient's balance in the portal and on the receipt. The aesthetics page shows courses and memberships for a skin clinic, the physiotherapy page shows blocks of sessions and class passes, and a demo will import your spreadsheet while you watch.