Record it as collected self-pay income on the day it lands in your account, not as a receivable. A superbill is a receipt you hand the client so they can ask their insurer for out-of-network reimbursement. It is not a claim you file, so no payer owes you anything, and whatever the insurer later pays your client never enters your ledger.
A superbill is an itemized receipt. It carries the dates of service, the procedure codes, your identifying details as the provider, and the amount the client paid at the session. The client sends it to their insurer, and the insurer reimburses the client.
What it is not: a claim, a bill to an insurer, or a promise of payment. Nothing in your books should be waiting on it.
A receivable exists when somebody owes you money for work you have already done. In a superbill practice the client has already paid you. If you book an "insurance receivable" anyway, you invent an asset that will never clear: it ages on the balance sheet forever, it overstates what the practice earned, and it makes your income look like it depends on an insurer you never contracted with.
If you also bill insurance panels directly, that is genuinely different work. There, a payer does owe you, and there are real receivables, claim statuses, and denial follow-up. That work sits outside what I do, and I will say so before we start anything.
Every session has two dates: the day you earned the fee and the day you collected it. Pick the method that matches how the practice actually runs, write it down, and stay with it.
For most cash-pay and superbill practices the simplest defensible choice is cash basis: income on the deposit date, which is the date the bank shows and the date you can prove. On an accrual basis, income lands on the service date and the deposit settles the receivable. What you do not want is a mix, decided session by session, because then no two months are comparable and the close becomes an argument instead of a check.
Card and platform payouts usually arrive in batches rather than one deposit per session. That is normal. The batch total is your deposit; the difference between the session amounts and the batch is the processor's fee, and it belongs in expenses.
That list is about an hour a month of work, and it is the difference between a set of books you can act on and a set you have to explain.
1. Recording what the client's insurer reimbursed them. That money is the client's, paid to the client, and it is not revenue you ever earned twice.
2. Netting processor fees into income. The deposit is smaller than the fees you charged, and once fees are quietly subtracted the deposit total never matches reported revenue again.
3. Leaving sliding-scale discounts off the books. Reported revenue then sits above what the bank received, with nothing on the page to explain the gap.
Three things: your billing system's totals (SimplePractice, Jane, TherapyNotes, or whatever you use), read-only access to the bank and card feeds, and a note about anything unusual that month, like a refund or a withheld payout.
No client names, and no session notes. In a cash-pay or superbill practice the totals version closes the books completely, and patient records never enter the engagement.
No. A superbill is a receipt for money the client already paid you. They use it to ask their insurer for out-of-network reimbursement, and the insurer pays them. You never bill the insurer, so nothing about it is insurance billing - and insurance billing is outside my scope anyway.
No. That payment goes from the insurer to the client. Your revenue is the fee the client paid you at the session; what they recover afterwards is their business, not a line in your books. Recording it would double-count income you never received.
You can, and for a very small practice it sometimes holds together for a while. What you lose is every number the bank cannot see: sliding-scale discounts, no-show fees, refunds, and the processor fees buried in a batch payout. The deposits still reconcile; the question "why is revenue higher than what I collected" stops having an answer.
Yes, fundamentally. Panel billing means a payer owes you money for services already delivered, so you have genuine receivables, claim statuses, and denial follow-up. That is insurance billing and it sits outside what I do. I take cash-pay and superbill practices precisely because the money path is short enough to close cleanly.
I close cash-pay and superbill therapy practices on a fixed calendar: reconciliation, financial statements, and a plain-English summary by day 15.
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