How it runs for behavioral health practices
Every deposit is tied to a payer batch or processor payout, adjustments are rebuilt by contract, splits are recalculated from collections, and deferred revenue and client credits are stated at each month-end. You receive an opening balance and a list of open items.
What is catch-up bookkeeping?
Catch-up bookkeeping is a one-time project that records and reconciles months or years of transactions that were never entered. The goal is a set of books where every bank, card and loan balance agrees with the statement and every period can be reported on. It ends when the backlog is current and reconciled, usually followed by ongoing monthly bookkeeping.
What we handle for behavioral health practices
- Rebuild collections and adjustments by payer from practice-management payment history month by month
- Tie every historical deposit to an ERA batch or processor payout net of fees and recoupments
- Recalculate clinician splits from collected revenue and compare with what was paid
- State deferred revenue, held claims and client credits as of each month-end
- Hand your CPA a clean opening balance and a complete year-end package
The KPI that matters here
Every back month reconciled and reviewed, with clinician split variances and client credits quantified at handover.
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
Catch-up bookkeeping in other industries
Frequently asked questions
What records do you need for a behavioral health catch-up?
Bank, card and loan statements, payroll registers, clinician agreements, the practice-management system's monthly payment, adjustment, session and aging reports, processor payout reports, clearinghouse and software invoices, and any lease agreements. We list what is missing after the first review and reconstruct what we can from the statements and reports that exist.
Will a catch-up change the income my practice reported?
It often does, because uncoded bank feeds count processor fees as revenue, miss recoupments, treat prepaid packages as earned, and record contractor clinician payments inconsistently. Rebuilding from the payment report produces revenue that ties to sessions and clinician cost that sits in the right month. Your CPA decides how any change affects prior filings; we provide the reconciled figures.
How long does a catch-up take for a group practice?
It depends on the number of months, clinicians, payers and payment channels, and on how complete the practice-management history is. A single-location group with processor and payer reports available moves quickly; a practice that changed platforms midway takes longer. Once we have reviewed your data we fix the scope and run it as a project with weekly progress notes.
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