Quote a treatment as a plan of visits, with insurance and third-party fees

This article describes a feature that is not released yet. It is for practices that sell treatment as a written quote, such as a private surgeon: your fee, the hospital, the anesthesiologist and follow-up visits, often partly paid by an insurer. It does not apply to your account today. Today a quote can only start a made-to-order job, not a series of appointments, and it has no idea of insurance or of fees paid to someone else.

What is planned:

• Service lines on a quote. A line can point to one of your services, with a number of visits (1 to 52) and a minimum number of days after the previous visit (0 to 365), for example a check-up at 7 days and another at 30. One visit can be marked as the plan's main visit, for example the surgery. A quote can have only one main visit.
• Who collects each line. Every line is either collected by your practice (the default), collected by your practice on behalf of a named person or business, or paid directly by the patient to a named person or business, such as the hospital. Lines paid directly are shown to the patient so they see the full cost, but Zelun never charges, takes a deposit on or invoices them. Your service lines are always collected by you. The quote shows three totals: what you collect for yourself, what you collect for others and what is paid directly to others.
• Insurance on a quote. You can add the insurer's name, whether the insurer pays your practice directly or the patient pays you and claims a reimbursement, the deductible, the coinsurance percentage (0 to 100) with an optional cap, an optional policy number and claim reference, and the authorization status: not requested, pending, authorized or denied, with an authorized amount when authorized. Each line is marked covered or not, and a line paid directly to someone else cannot be covered. Zelun works out the insurer's share and the patient's share. The deductible is the amount stated for this bill by the insurer, entered per quote. Zelun does not track a policy's deductible across years.
• A plan, not an order. When the patient approves a quote that has at least one service line, Zelun creates a treatment plan instead of a made-to-order job. Quotes without service lines keep creating orders as they do today. The plan has one planned visit per visit on the quote, each starting as not booked, and the patient gets a private page for the plan.
• Paying for the plan. The deposit is your quote deposit percentage of the patient's share when you use one, otherwise the full patient share. The balance is the rest, and it is due by the start of the main visit. Lines paid directly to someone else are never part of these payments. The patient pays online through your connected payout account, or an owner or staff member of the branch records a payment at the desk in cash, on a card terminal or by transfer (with its reference, and the exact outstanding amount). Where there is no connected payout account the plan page says payment is taken at your practice.
• Booking the visits. The patient books each visit from the plan page, and staff can book from the diary by choosing the plan and the visit. Visits are ordinary appointments with your normal availability, hours and closures, with no second booking deposit. Spacing is enforced from the previous visit once that one is booked. The patient cannot book the main visit or any later visit until the deposit is paid, though visits before the main one can be booked earlier. Staff can book any visit, and the appointment shows that the deposit is still outstanding. While the balance is unpaid, the main visit shows it to staff in the diary and at checkout, but it never blocks check-in or finishing the visit.
• Visit status. A visit reads booked while its appointment is live, completed after checkout, not booked again if the appointment is cancelled or moved away, and missed after a no-show. A missed visit can be booked again. Your usual cancellation, late-reschedule and no-show fee rules apply to these appointments. When every visit is completed the plan reads completed. At checkout, a plan visit shows the plan service as included, at no extra charge.
• Insurance after approval. An owner or branch staff member can update the authorization status, the authorized amount and the claim reference. Zelun recalculates the shares and leaves a paid deposit as it is. The balance becomes the new patient share minus what the patient already paid. If the patient has paid more than the new share, the excess is offered back as a refund or account credit. Each update is recorded and a change in the patient's share is told to the patient.
• What the insurer owes. For a plan where the insurer pays your practice directly, the plan carries an amount owed by the insurer, shown as expected until you record the payment with the amount, date and a reference. It reads paid when it equals the share, or short paid with the shortfall when it is less; a short-paid plan can take further payments, or an owner can write the shortfall off with a reason. A shortfall is never added to the patient's balance on its own, and insurer payments are not collected through your payout account. A plan's Claim builds the packet the insurer asks for, keeps its attachments and follows the claim until it is paid; for a plan where the patient files their own reimbursement, their plan page offers Documents for your reimbursement. Zelun does not send the claim, invoice the insurer or check eligibility, so you do those outside Zelun.
• Cancelling a plan. An owner can cancel an active plan with a reason and an amount of the patient's paid total that you keep, from nothing up to everything paid, with a reason whenever you keep anything. Unbooked and missed visits are cancelled, booked appointments stay for staff to cancel one by one, and unpaid payments are voided. The rest goes back to the patient under the same refund-or-credit rules as a cancelled order. An owner can also give a goodwill refund on a plan in any status.
• The patient's plan page. It shows each visit with its status and date, the deposit and balance, any refund, invoices to download, the insurer share and coverage mode, and the directly paid lines for information. It does not show your internal notes. The patient is told when the plan is created, when a payment is confirmed, when the share changes, three days before the main visit if the balance is unpaid, on cancellation, on refunds and when an invoice is issued.
• Reviewing the quote. The patient sees the lines grouped by who is paid, a subtotal for each, the visits each service includes, the total they pay your practice, and, with insurance, the insurer's name, the mode, deductible, coinsurance, authorization status, the insurer share and the patient share. Amounts are labelled as an estimate until authorization is authorized, and only the last four characters of the policy number are shown.
• Invoicing (CFDI). The plan deposit can be invoiced as an anticipo and the paid patient share can be invoiced from the plan, relating the anticipo. Lines collected for others and lines paid directly are left out. Tax on each line follows the rate set on the service, or your location's rate for other items. Zelun does not apply any automatic exemption, so you control it.
• Private notifications. An owner can turn on a company setting, off by default and available on every plan, so that no message to your clients contains service names, line-item text, insurer names, policy numbers, claim references or client notes, on any channel, including calendar files. Messages use general wording such as "your appointment" or "your plan" and still carry the date and time, the location and the link. While it is on, no client details are sent to an AI service to draft a client message, and messages go out on approved WhatsApp templates or fall back to SMS where allowed.

About the money: online plan payments go to your own connected payout account, and Zelun does not hold your funds. A platform fee applies to payments taken online, set by Zelun and separate from the payment processor's own fees, as for booking deposits. A line you collect for someone else lands in your account, and you settle with that person outside Zelun.

1. Your services set up, because service lines point to them.
2. A connected payout account if patients should pay online. See the article on payouts and deposits.
3. Your quote deposit percentage, if you want less than the full amount up front. See the article on quotes and orders.
4. For invoices, your CFDI set-up.

The screens for this feature are not final, so exact button names are not listed yet. In outline, once it is released:

1. Build the quote with service lines and any other items, say who collects each line and add the insurer's details if there is insurance.
2. Send it to the patient. They review the breakdown and approve it.
3. Zelun creates the plan and the patient receives the plan page.
4. The patient pays the deposit and books the visits, or you do it for them from the diary.
5. Record the authorization when it arrives, and record the insurer's payment when it comes in.

Your patients see the quote breakdown, the plan page, the booking page limited to the right service and the messages listed above. With private notifications on, those messages carry no clinical detail.

• Treating this as available now. It is not released.
• Expecting Zelun to bill the patient for an insurer shortfall. It is shown, never added automatically. You decide.
• Expecting Zelun to invoice the insurer. Not yet.
• Entering the deductible for the whole policy year. Enter the amount the insurer states for this bill.
• Expecting the payee to be paid by Zelun. Lines paid directly are never charged by Zelun, and lines you collect for others land in your account.

Quotes and orders, collecting order payments, CFDI invoicing and payouts and deposits are explained in their own articles.