How it runs for behavioral health practices
We reconcile operating, payroll and reserve accounts monthly, match each deposit to the payment report in your practice-management system by payer and date, and post processing fees and recoupments to their own accounts. Practice cards are reconciled to receipts, and anything unexplained is listed rather than plugged.
What is a bank reconciliation service?
A bank reconciliation service compares the transactions in your accounting software with the transactions on your bank and credit-card statements and explains every difference. The goal is a ledger balance that agrees with the statement after timing items such as outstanding checks and deposits in transit. Done monthly, it catches missing entries, duplicates, bank errors and fraud early.
What we handle for behavioral health practices
- Match each payer EFT to the ERA batch and each processor payout to the copay report
- Post processing fees, recoupments and returned client payments separately from collections
- Reconcile practice credit cards to receipts for software, supplies and continuing education
- Reconcile payroll clearing to the Gusto or ADP register each pay run
- Send a monthly list of unexplained bank items, each with a suggested action
The KPI that matters here
Zero unreconciled items older than 30 days across operating, payroll and processor accounts, with fees and recoupments fully posted.
Behavioral health compliance notes
HIPAA
Session notes, claims, ERAs and client ledgers are protected health information. We sign a BAA, staff are HIPAA-trained, access to the practice-management system is role-limited with MFA, and the accounting file receives batch totals and claim numbers rather than client names or diagnoses.
42 CFR Part 2
Records from a federally assisted substance-use disorder program carry stricter confidentiality rules than HIPAA alone, including specific consent before disclosure. For programs covered by Part 2, billing staff work only inside your system, no Part 2 record is exported to the ledger or to email, and any request for records is routed to your privacy officer.
Payer contracts and credentialing
Each payer contract sets allowed amounts by CPT code, timely-filing windows, telehealth rules and how recoupments are handled. We post adjustments by contract, log clinician credentialing effective dates so held sessions are billed once approved, and reconcile recoupments against the sessions they reverse rather than netting them silently.
Self-pay estimates and card on file
Self-pay and uninsured clients are entitled to a good faith estimate under the No Surprises Act, and card-on-file charges for copays and no-show fees require the client's written consent. We record estimates and consents with the client's financial arrangement, and our agents never take or store card numbers; charges run through your own processor.
Behavioral health software we work in
- QuickBooks Online
- Xero
- Stripe
- Gusto
- Bill.com
- TherapyNotes
- SimplePractice
- Valant
- Kipu
- All 50 platforms
More for behavioral health practices
Other services for behavioral health
Bank reconciliation in other industries
Frequently asked questions
Why is the payer deposit smaller than the ERA total?
Usually because the payer applied a recoupment for an earlier overpayment, an interest adjustment or an offset against another provider under the same tax ID. The ERA shows these as separate adjustment lines. We post the gross payments to the sessions, the recoupment against the session it reverses, and match the net deposit, so nothing is netted silently.
How do you reconcile copay payouts from the card-on-file processor?
The processor's payout report lists the copays, no-show fees and self-pay charges settled in each payout and the fee deducted. We tie each payout to the bank deposit, the charges to the client payment report in your practice-management system, and post the fee to merchant expense. Refunds and disputed charges are matched when the processor returns or withholds the funds.
What if the payment report and the bank never agree?
The most common causes are timing, since processor payouts settle days after the session; fees and recoupments, which the bank deducts but the payment report does not show; and posting errors, such as a copay entered twice or an EOB applied to the wrong client. We separate the first two and list the third for your office manager so the practice-management ledger is corrected as well.
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