How it runs for behavioral health practices
The controller models a hire against credentialing lag, an intensive program, a new suite or leaving a low-paying panel, prepares lender and partner buy-in packages, supports your CPA at year-end, and holds a monthly call with the owner on payer mix, capacity and cash.
What are outsourced controller services?
Outsourced controller services provide the review layer that sits between bookkeeping and the owner: a senior accountant who checks the close, owns the accounting policies, tests the controls around cash and spending, and explains the financial statements. The controller does not do daily posting. They make sure what was posted is right and documented before anyone relies on it.
What we handle for behavioral health practices
- Review each close for payer tie-out, contract adjustments and deferred revenue
- Model a clinician hire, a new program or leaving a payer panel before you decide
- Prepare lender, partner buy-in and grant reporting financial packages
- Approve split and supervision calculations and own the close calendar
- Hold a monthly call with the owner on payer mix, capacity and cash
The KPI that matters here
Each close is reviewed and signed off by the controller, with a written summary of exceptions and pending decisions.
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
Controller services in other industries
Frequently asked questions
When does a therapy group need a controller?
When the owner is weighing a hire, a new program, a second location or a panel exit without a model, when a lender or a prospective partner wants reviewed monthly financials, when a grant or county contract requires cost reporting, or when split calculations keep causing disputes. The controller adds review and judgment on top of bookkeeping already in place.
Can the controller help decide whether to leave a payer panel?
Yes. We pull sessions, collections and adjustments for that payer, calculate the revenue recovered if clients move to self-pay or another plan, and model outcomes across several retention assumptions, including the caseload effect on clinicians paid by split. The result is a range, not a prediction. The decision and any contract notice requirements belong to you and your counsel.
How does the controller support a partner buy-in or a sale?
For a buyer or incoming partner, we review the financials for revenue tied to posted collections, adjustments by contract, clinician cost by provider, deferred revenue and add-backs. For a seller, we assemble reconciled statements and a schedule of normalizing adjustments. Valuation and terms belong to your broker and attorney; we make sure the numbers they rely on hold up.
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