How it runs for behavioral health practices
Our ReconBot workflow pulls each processor's payout report, ties every payout to a bank deposit and to the client payments it settles, posts fees, refunds and chargebacks separately, and reconciles each processor balance to a clearing account at every close. Held payouts are flagged the day they appear.
What is payment processor reconciliation?
Payment processor reconciliation is the work of proving that the money a processor or marketplace deposits equals your gross sales less its fees, refunds, chargebacks, reserves and adjustments for the same settlement period. Each payout is broken into its parts and posted so revenue, fees and sales tax are correct and the bank deposit matches to the cent.
What we handle for behavioral health practices
- Match each processor payout to a bank deposit and the client charges it settles
- Reconcile in-office terminal batches and portal payments to the daily client payment report
- Post processing fees, refunds and chargebacks separately from collections
- Catch held, delayed or reversed payouts before they distort collections
- Tie every processor balance to its ledger clearing account at each close
The KPI that matters here
All processor payouts matched to deposits and client payments within two business days, with fees posted separately.
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
Payment processor reconciliation in other industries
Frequently asked questions
Why don't the copay deposits match what we charged?
Because the processor combines several days of charges into one payout, subtracts its fee, and sometimes holds back a refund or a dispute from an earlier week. A charge on Friday may settle the following Tuesday with Monday's charges. Reconciling from the payout report rather than the bank feed makes each deposit traceable to specific clients and sessions.
How do you handle a client chargeback on a no-show fee?
The disputed amount is recorded against the client's account, the dispute fee is posted, and we assemble the signed cancellation policy, card-on-file consent and appointment history you would need to respond. Responding is your decision. If the dispute is lost, the balance returns to the client aging with a note; if won, the reversal is matched when the processor returns the funds.
Can you reconcile the processor built into our practice-management system?
Yes. Integrated processors post client payments to the ledger automatically, but the payout still arrives net of fees on the processor's schedule, and the practice-management report rarely shows the fee. We reconcile the integrated payment report to the payout, the payout to the bank, and post the fees, so the client ledger, the processor and the bank all agree each month.
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