This guide covers how to manage billing for your entire practice from the Billing tab in Practice HQ — including insurance claims, cash-pay invoices, ERA processing, and eligibility verification.
In this article:
1. Billing command center overview
The Practice Billing tab is your central hub for all billing operations. The sidebar organizes everything into sections:
Session Billing — queue of unbilled sessions ready to be invoiced or submitted as claims
Manage Claims — track submitted, secondary, and denied claims
Payment Posting — process ERA (Electronic Remittance Advice) payments from insurers
Manage Cash Pay — track outstanding, overdue, and paid invoices
Eligibility — verify client insurance eligibility
Setup — configure payment processing and insurance
2. Setting up payment processing
Where to find it: Billing → Setup → Billing Setup → Payment Processing.
Click Connect Stripe Account.
Complete the Stripe onboarding flow with your practice's business info and banking details.
This shared Stripe account handles client payments for all therapists in the practice.
3. Setting up insurance
Where to find it: Billing → Setup → Insurance Setup.
Enter your group provider information: organization name, Group NPI, Tax ID (EIN), contact details, and taxonomy code.
Add accepted payers — the insurance companies you bill.
For each payer, enroll for the transaction types you need: claims (CMS-1500), ERAs, and eligibility verification.
💡 Enrollment is processed through our clearinghouse and may take 5–15 business days per payer.
4. Billing sessions
Where to find it: Billing → Session Billing.
This shows all unbilled sessions across your practice. You can:
Filter by therapist, billing type (insurance/cash), and status.
For insurance clients: select sessions and click Create Claim. The system validates insurance info before submission.
For cash-pay clients: select sessions and click Create Invoice. Invoices are sent to clients with a secure payment link.
You can process sessions in bulk — select multiple sessions for the same client or across clients.
5. Tracking insurance claims
Where to find it: Billing → Manage Claims.
Three sub-tabs:
Submitted — in-flight claims with status tracking and days-since-submission. Claims aging beyond 30 days are highlighted.
Secondary — claims where the primary payer paid partially and you need to bill a secondary insurer. Supports batch submission.
Denied — rejected claims with denial codes and reasons. For each, you can resubmit, correct, appeal, or write off.
6. Processing ERA payments
Where to find it: Billing → Payment Posting.
When insurers send payment, you receive an ERA (835 electronic file). Each ERA shows:
Check number, payer, date, and total amount
Claim-by-claim breakdown: billed, allowed, paid, and client responsibility
Adjustments (contractual, write-off, deductible, copay, coinsurance)
Match ERA payments to your claims and post the payment. Any client responsibility (copays, deductibles, coinsurance) can be converted into a client invoice.
7. Managing cash-pay invoices
Where to find it: Billing → Manage Cash Pay.
Outstanding — invoices sent but not yet paid
Overdue — past-due invoices
Paid — completed payments
Invoice statuses: Draft, Sending, Open, Paid, Overdue, Void, Uncollectible.
8. Verifying eligibility
Where to find it: Billing → Eligibility.
Select a client and their payer.
Run an eligibility check — results show coverage status, copay, deductible, and coinsurance details.
💡 Each eligibility check costs $0.15.
9. Billing overview dashboard
The Billing tab's default view shows key metrics at a glance:
Monthly revenue
Outstanding invoice amounts
Pending insurance claims
Recent activity feed (payments, denials, ERAs, invoices)
Quick action cards: denied claims, ERAs to process, claims ready to submit, expiring prior authorizations
Frequently asked questions
Can individual therapists still manage their own billing?
Therapists can view their own billing panel for their clients, but practice-level billing operations (bulk claims, ERA processing, etc.) are managed through Practice HQ.
How does auto-billing work at the practice level?
Auto-billing processes all ready items nightly — cash-pay invoices, insurance claims, and client responsibility invoices. It applies to all therapists in the practice.
What's the difference between Session Billing and Manage Claims?
Session Billing is where you create claims and invoices from completed sessions. Manage Claims is where you track claims after they've been submitted to insurance.