How it runs for behavioral health practices
Each balance-sheet account is reconciled, and under Two-Tier Review a team lead signs off before the package leaves by the fifth business day.
What is month-end close outsourcing?
Month-end close outsourcing means an external accounting team performs the steps that turn a month of transactions into finished financial statements: reconciling every account, posting accruals, prepaids and depreciation, checking cut-off, reviewing and locking the period. You keep your software and your accountant. The provider runs the checklist on an agreed calendar and hands you reviewed statements.
What we handle for behavioral health practices
- Cut off sessions, claims and payments from the practice-management system at month-end
- Accrue delivered-but-unbilled sessions and held credentialing claims with an expected value
- Accrue clinician splits for sessions collected after period end and reverse next month
- Release prepaid intensive-program and self-pay package revenue as sessions are delivered
- Finish each close with maker-checker sign-off and a logged review trail
The KPI that matters here
Close released by the fifth business day with posted collections tied to the bank and clinician cost reported as a percent of collections.
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
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Frequently asked questions
Why accrue unbilled sessions at month-end?
Because notes are often signed and claims released days after the session, so a month that ends on a Friday can leave a week of delivered sessions unbilled. Without an accrual that revenue lands in the next month while the clinician cost for those sessions may not, and the two months become impossible to compare. We accrue from the appointment report at the expected allowed amount and reverse when claims post.
How is revenue recognized for intensive programs and prepaid packages?
An intensive outpatient or partial hospitalization program billed per diem is recognized on the days the client attended, from the attendance record. A self-pay package or retainer paid up front is recorded as deferred revenue and released as each session is delivered. This keeps a strong cash month from looking like a strong revenue month and shows the obligation on the balance sheet.
What does the close package contain for a behavioral health practice?
A P&L by clinician and by program, a balance sheet with every account reconciled, an insurance aging by payer tied to the ledger, a client-balance summary, a deferred revenue and held-claims schedule, clinician cost as a percent of collections, and a short note on what moved. The CloseTrack log records who prepared and reviewed each step, which partners and lenders appreciate.
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