Building Your Business:
‍Engaging Patients With Packages and Recurring Memberships

For nurse practitioners (NPs) in independent practice, finding ways to improve patient retention can help drive financial stability. Packages and recurring memberships offer a sustainable way to enhance engagement, generate predictable revenue, and streamline service delivery. However, implementing these models effectively requires careful planning—from pricing and perks to compliance and tracking.

While packages and memberships have traditionally been much more common in cash-pay NP practices with non-primary care specialities like medspas, weight loss and IV, or functional and integrative clinics, they are also increasingly used in primary care and insurance-based practices to drive value in addition to/beyond standard insurance coverage.

Whether you're already offering memberships and packages or considering adding them to your practice, this guide provides actionable insights to help you maximize their impact while avoiding common pitfalls. 

We’ll walk you through designing your approach while avoiding the pitfalls.


Designing Your Approach
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Packages and Memberships - deciding what to offer

There are a few ways that you can set up package and membership options - and they can be really useful for different types of services
    • Service-Based Packages: Bundle related treatments (e.g., Botox treatments, IVs, nutrition consults - this can apply to most services)
          ◦ This can be anything from the basic “Buy 3, Get 1 Free,” to a “Pick 3 of these 15 Services” - but more on that later…
     • Prepaid Credits: Allow patients to purchase credits for services at a discount
          ◦ E.g., buy $550 of services at the price of $500
     • Time-Based Memberships: Offer monthly, quarterly or annual subscriptions with exclusive perks like discounted services, priority booking, or direct messaging for a provider - this can be combined with packages and pre-paid credits. Some examples include:
          ◦ Direct primary care membership that gives you immediate access to message your provider and priority same-day appointments for a monthly fee
          ◦ Medspa VIP membership for $199 a month gets you unlimited access to the services like infrared sauna and a 10% discount on products
          ◦ Or, the VIP Subscription includes 3 massages and $150 of products to spend however you’d like
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All of these help you smooth out your payment cycle, get upfront commitments from your patients and drive revenue. And you can manage all of these in OptiMantra!

Perks - including more than services

‍Think about what other incentives - beyond the services themselves - you want to include. These can be as important in driving patient engagement as the package itself!
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     • Better Appointment Access - like early appointment booking, priority or same-day scheduling, walk-in support
     • Direct Provider Access - like access to patient portal messaging with the provider
     • Exclusive Discounts - like 10% off additional treatments or products you sell
    • Loyalty Points or Rewards for continued use

The right EMR can make this easy to track - with OptiMantra’s practice management features, for example, you can automatically bake in selective discounts (e.g., on services or inventory) with your packages.

Pricing - taking payment

How you set up the payment for the packages can play an important role in driving patient commitments and/or making your services more affordable for your patients.

Some options include:
    • Upfront Payment: Ideal for packages (e.g., “Buy 5, Get 1 Free”)
     • Monthly Auto-Pay: For memberships, ensure auto-billing is enabled and all the requisite paperwork is signed (more on that below)
     •  Custom Financing: Offer installment plans for high-ticket treatments - like if you have a multi-part treatments - to make them more accessible 

You can always couple multiple items - e.g., allow patients to buy a recurring package that credits to their account every month!


Avoiding the Pitfalls
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Keep It Manageable - Don’t overcomplicate

There are A LOT of possibilities as you think through how to set up your packages and recurring memberships, so the biggest advice we have is - keep it simple. Too complicated, and too complicated too soon, is offputting - and way more overhead to track. Your front desk should be able to easily explain the different packages and value propositions to patients - ideally off the top of their heads.
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     • Start with a few membership or package types, and then add to them as you go. 
     • Adding is easy, so make sure you also quarterly review your sales and cut any packages or memberships which aren’t as successful -> use it as an opportunity to re-engage those patients and move them to your higher-performing models.

Keeping it simple also has a huge advantage - driving upsells! Making it clear to patients what they get now - and what they could be getting - helps them engage more deeply with your services.
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    • If, for example, package 1 gives you access to buy-3-get-1-free of your low-priced IVs;  then package 2 gives access to buy-3-get-1-free for your more expensive IVs. Simple to explain, and if you want to add another type of IV as a patient, you have to buy the next package (or membership).

Track Usage - This is critical for your tax liability too

‍Properly tracking package usage and expiration is not only essential for patient management but also impacts your financial reporting and tax liability. Unused package balances may be considered deferred revenue, which can affect how you report earnings.
    • Ensure that package balances are counted down directly - and associated with Superbills for your patients - so providers and staff can easily track usage and remaining sessions. You’ll want to make sure you track down not just package usage, but how that impacts the outstanding dollar liability as well.
     • Set up notifications for patients to remind them of unused sessions before they expire or create text and email campaigns to engage those patients, helping to maximize engagement and minimize service gaps.
     • Establish clear expiration policies while allowing case-by-case extensions for exceptional circumstances, ensuring compliance while maintaining a patient-friendly experience.
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Clarify Terms - And protect yourself against disputes
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‍Offering high-value packages and memberships increases your exposure to transaction disputes. A dispute occurs when a patient claims they didn’t authorize a charge and asks their bank to reverse the transaction. These disputes—often called chargebacks—can happen months after the original purchase, sometimes even after the patient has already used the services.

Since the patient’s bank ultimately decides whether a dispute is valid, you must proactively protect your business by ensuring you have rock-solid proof of the purchase and agreement terms.

Here’s how:
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Get Signed Consents at Purchase
     • Clearly outline refund, cancellation, and expiration policies in writing.
     • Use a signed consent form (like the one available in OptiMantra EMR) to ensure patients acknowledge the terms before purchase.

Specify Service Restrictions & Commitment Periods
     • Define any restrictions or limitations (e.g., non-transferability, expiration dates, cancellation penalties).
     • Make sure membership terms (including auto-renewal and minimum commitment periods) are clearly communicated at the time of purchase.

Take Initial Payments In-Person When Possible
     • Collecting the first payment in-office via a physical card terminal (such as those integrated with Fiserv in OptiMantra) helps establish that the card was present, reducing fraud-related chargebacks.

Maintain Detailed Documentation
     • Keep records of all patient communications, invoices, and signed agreements.
     • If a dispute arises, submit strong evidence (signed contracts, usage history, proof of in-person payment) to improve your chances of winning the case.

To recap - 
     • There are lots of ways to do packages and recurring memberships, so take the time to plan what is going to be the right fit for your patients! Package, pricing, and perks all play a part
     • Don’t overcomplicate at the beginning.
     • Once you have your approach in place - track, track, track packages and paperwork to protect yourself and your business.