Case study: how a Colombian clinic collects payments from international patients

A clinic in Bogotá confirms a treatment plan for a patient who lives in Toronto. The patient accepts the quote, but before the clinic blocks a surgery date it needs two things: a deposit that confirms the booking, and certainty that the deposit, and the balance that follows, will reconcile cleanly against the invoice and the patient's administrative file. Collecting from someone who lives in another country, without a proprietary payment gateway or a foreign bank account, is an operational problem long before it is a medical one.

In Soulbit Academy we present this case as an illustrative, fictional example, not as a real client. The clinic does not exist and every figure is a working assumption. The goal is to show how a clinic organizes collections from international patients when it uses payment links and collection QR codes in stablecoin, and which part of the process remains the company's own responsibility. Because this is a healthcare case, the article avoids any health data: no procedure, diagnosis or medical history is named, only "the treatment plan" as an administrative reference. If you are a patient researching care in Colombia, or a facilitator coordinating medical travel for one, the same payment mechanics apply to how you would be asked to pay.

The clinic's profile (illustrative case)

Clínica Altozano is a fictional clinic based in Bogotá that treats patients from the United States, Canada and Spain, on top of its local patient base. Every figure below is a working assumption, not real data from any provider. The assumptions are these:

• About 15 international patients a month who confirm a treatment plan (assumption).
• A deposit equal to 40% of the plan's value to hold a date, paid before travel (assumption).
• A remaining balance of 60%, paid on the day of discharge (assumption).
• Treatment plan values between 3,000 and 8,000 dollars, depending on the case (assumption).
• A three-person administrative team: an administrative manager, an international patient coordinator and an external accountant.

Before issuing its first collection, the clinic completed its own KYB process to open its account on the platform, as any company using it does. Until now, the deposit arrived by international wire transfer, with several days of waiting and a fee that either the patient or the clinic absorbed depending on the bank. The balance was collected by card terminal on arrival, once the patient was physically at the clinic.

Why collecting from an international patient is not the same as a local payment

Collecting from an international patient adds two steps a local payment does not have: confirming the money arrived before locking in a schedule slot, and documenting the transaction for Colombia's exchange and tax regime. A local payment in pesos triggers neither obligation.

Clínica Altozano's cycle has nine steps. The first is quoting the treatment plan in dollars. The second is the electronic invoice. The third is collecting the deposit through a payment link or collection QR. The fourth is the on-chain confirmation of that payment. The fifth is collecting the balance after the procedure. The sixth is reconciling each payment against the invoice and the patient's file. The seventh is converting the accumulated balance to pesos through the local banking rail, when the clinic needs it. The eighth is the exchange and tax paperwork tied to the transaction. The ninth is the cancellation and refund policy.

Does the clinic need to build a checkout into its own website to collect from the patient?

No. A payment link or collection QR requires no technical integration: it is generated from a dashboard and shared by email or message, without touching the clinic's site. The difference from a local collection is the instrument, not the development work.

The collection journey, step by step

Collecting from an international patient starts at the quote and ends at reconciliation, not at the balance payment. Each step leaves a record the next step depends on.

First, the coordinator sends the treatment plan quote in dollars, after a remote evaluation with the medical team. Second, once the patient accepts, the clinic issues the electronic invoice for the deposit, under Colombia's DIAN electronic invoicing rules. Third, the clinic generates a payment link or QR code for the deposit amount and sends it to the patient before the travel date. Fourth, the patient pays in USDC or USDT from their own wallet, and the network records the transaction with a unique identifier, independently verifiable from any bank statement. Fifth, after the procedure is complete, the clinic generates a second link or QR for the balance, which the patient pays on the day of discharge. Sixth, the administrative team matches every on-chain identifier against the invoice and the patient's file, without folding any health data into that match.

Table 1 compares the clinic's previous collection process with the one it runs after adding payment links and QR codes.

Collection step	Before (traditional banking circuit)	After (payment link and QR)
Quote and acceptance	Dollar quote by email, unchanged at this step	Same: dollar quote by email
Collecting the deposit	SWIFT wire, several days of waiting plus a bank fee	Payment link or QR; patient pays in USDC or USDT in minutes
Verifying the payment	Waiting for the bank statement to confirm the funds arrived	On-chain identifier, verifiable right away
Collecting the balance	Card terminal or a new wire on the day of discharge	New payment link or QR, same mechanism as the deposit
Converting to pesos	Depends on the receiving bank and its internal rate	Under a visible eOTC quote, through the local banking rail
Reconciliation	Manual match against the statement, sometimes days later	Same-day match between identifier, invoice and file

What happens if the patient does not hold stablecoins?

Then the payment link does not apply to that collection, and the clinic falls back on its usual wire or card circuit for that particular patient. It is worth confirming this when sending the quote, before generating any link, the same way any other payment method is agreed with a new patient.

Deposit, balance and reconciliation with the invoice and the patient

Reconciling a patient payment means matching, for every collection, three records: the on-chain identifier, the electronic invoice and the patient's administrative file. Clínica Altozano reconciles each payment the same day it receives it, not at month-end close, following a logic close to the one in reconciling stablecoin payments with accounting.

The administrative file keeps only what the collection needs: name, country, contact dates and the agreed plan. It holds no diagnosis, no named procedure and no medical history, and that file is handled with the same care as any sensitive personal data, without being detailed in this article. Table 2 shows the four records that get matched in every reconciliation.

Record the clinic reconciles	What it contains	What it matches against
On-chain transaction identifier	Amount in USDC or USDT, date and time, network used	Electronic invoice and patient file
Electronic invoice (DIAN)	Invoiced amount, whether deposit or balance, patient as the billed client	Payment receipt and agreed plan
Patient's administrative file	Name, country, contact dates; no health data	Accepted quote and procedure calendar
Peso conversion receipt (if applicable)	Converted amount, eOTC rate, date	Clinic's treasury ledger and peso budget

Two rules keep this reconciliation orderly. The first is closing the match the same day, because a traveling patient generates fast questions about their balance. The second is keeping each reconciliation as its own record, with its date and version, because it becomes the reference if the patient or their insurer later asks for proof.

Converting to pesos and the exchange and tax paperwork

Collecting in stablecoin does not take a Colombian clinic out of the foreign exchange regime or its invoicing obligations: both still apply exactly as they would after a wire transfer.

Colombia's foreign exchange regime is set out in Resolución Externa 1 de 2018 of the Banco de la República's board. That rule requires income from an exported service to be channeled through the exchange market when the underlying transaction must be mandatorily channeled, and the foreign currency repatriated within six months of receipt. The general foreign exchange framework for companies in Colombia is covered in this guide.

On VAT, a health service rendered to a foreign patient is not automatically exempt. DIAN's Concepto 008660 de 2024 confirms that the exemption under article 481, literal e, of Colombia's Tax Code, developed by Decreto 1794 de 2013, requires the service to be rendered in Colombia and used exclusively abroad. A procedure performed on a patient who is physically present in the country is typically enjoyed inside Colombia, not outside it, so Clínica Altozano does not assume the exemption by default: it reviews each case with its accountant before invoicing.

Who files the exchange declaration for this collection?

The clinic, not Soulbit. The platform confirms the stablecoin payment and, if the clinic requests it, converts the balance to pesos under an eOTC quote (OTC by quote, with no order book), but it does not file the exchange declaration or repatriate the currency on the company's behalf. The electronic sales invoice remains mandatory, issued under the system regulated by DIAN's Resolución 165 de 2023.

Medical tourism into Colombia has been growing: between January and August 2026, 21,034 non-resident foreigners entered the country for medical treatment, 17.6% more than in the same period of 2025, according to Migración Colombia figures cited by Portafolio. That growth is part of why more clinics are evaluating collection mechanisms beyond the traditional wire transfer.

Cancellations, refunds and protecting the patient's data

A cancellation policy needs to be set before the deposit is collected, not after the first cancellation arrives. As a working assumption, Clínica Altozano sets the deposit as 100% refundable if the patient cancels more than 30 days ahead, 50% refundable between 30 and 10 days, and non-refundable inside the last 10 days, except for a justified medical reason.

How is a deposit that was already paid in stablecoin refunded?

As a new payment. Soulbit does not reverse a confirmed transaction and does not manage the dispute between the clinic and the patient: if the clinic decides to refund, it generates a payment to the patient's wallet, with its own identifier and its own reconciliation, separate from the original collection.

On patient data, the clinic handles personal information, including any sensitive data, under Colombia's data protection rules enforced by the Superintendencia de Industria y Comercio, regardless of how the service was collected. This article does not detail what clinical data the clinic keeps or how it protects it, because that is not its subject: the focus here is the collection and the administrative reconciliation, not the medical record.

What Soulbit's V1 delivers here, and what it does not solve

Soulbit's V1 delivers five capabilities: payment links, collection QR codes, on-chain confirmation, eOTC conversion to pesos through the local banking rail, and institutional custody while the balance sits on the platform. It does not deliver card collection from the patient, an embedded checkout on the clinic's website, or automatic charges: every collection is a link or a code the clinic issues for that patient and that amount. It also does not issue the invoice, file the exchange declaration, or repatriate the currency on the company's behalf; and for a patient without stablecoins, the payment link simply does not apply, so the clinic falls back on its usual bank or card circuit.

Three conclusions carry over to other clinics with international patients. First, a payment link solves the collection, not the tax or exchange obligation, which remains the company's responsibility. Second, keeping the administrative file separate from the clinical file makes reconciliation possible without exposing sensitive information. Third, a cancellation policy written before the first collection avoids negotiating terms in the middle of a real cancellation.

For collecting from a higher volume of international clients, the case of a SaaS startup that collects in USDC from clients in 12 countries shows how the same mechanism scales outside the healthcare sector.