Sessions, Setup & Billing Workflow: Building an Efficient Billing Process

Every practice has unique billing needs. Whether you’re setting up billing for the first time, managing third-party payors, offering sliding-scale services, or looking to streamline administrative tasks, a well-designed workflow can make a significant difference.

During our recent Client Billing and Integrated Payments webinar, clinicians asked a wide range of questions about billing setup, session management, reporting, discounts, and complex payment scenarios. Below, we’ve gathered the most common questions and answers to help you build a billing workflow that works for your practice.

Sessions, Setup & Billing Workflow 

Owl Practice Help Centre Articles: Stripe Payments and Billing

Q: Are there any additional fees to using Stripe or processing payments through Owl directly? 

A: There aren’t any set-up fees or monthly service fees for using Stripe/Integrated payments through Owl. There are standard processing fees of 2.9% + $0.30 per transactions that would be applicable for any online credit card processing.  
 
This means there isn’t a PCI fee, a fee to keep your account open, or minimum usage fee either. The only fee that would be applied is the standard processing fees noted above, and they are taken out at the time of the transaction. You will not have to calculate these fees yourself as Stripe completes the calculation, and you will not receive a separate statement for the fees or see a withdrawal from your bank account for the fees. 

Q: Can I bill for charges that are not tied to a session, for example materials or a late fee? 

A: Late fees and something like materials have different ways of being handled and billed.  

• Late Fees: within Settings → Services and Fees, you can adjust your services to include a late cancellation fee and even a no-show fee. In the event that a client late cancels or no shows, you can mark attendance accordingly and the respective fee will be applied for that session. 
• Materials, Report Writing Fees, etc.: you can create Non-Session charges within Settings → Services and Fees. These are items that you would like to bill for but are not tied to a specific session. 

Q: I invoice clients in advance, monthly, but the system requires a session to be marked “attended” before I can create an invoice. Is there a better workflow than the manual one I’ve built? 

A: If you bill clients in advance, like having a retainer fee, then there are two ways you can accomplish this: 

• Record Transaction: use the Record Transaction button to charge your clients ahead of time, so there is a credit balance for their account that you can use against future session invoices. The caveat to this is that there will not be an initial invoice, just a receipt stating that payment was made. You can add a note to the receipt though, if you’d like to provide any additional context for the charge. 
• Duplicate Sessions: this does require more effort, but it does allow you to bill upfront with an invoice listing the future sessions. 
  • Set invoicing and receipting items all to “Manual” first, so you can generate one invoice for the sessions and adjust the invoices and receipts prior to finalizing them for the client. 
  • Next create the client’s sessions with duplicates: one session will be their regular session and the other will have their attendance marked to generate the invoice against. 
  • After all sessions are created and the duplicates marked with attendance, create the invoice for the sessions with the attendance marked. 
  • When generating the invoice, uncheck the “Show Attendance” box so it does not appear as an attended session on the invoice and send to your client. 
  • Record a transaction for the invoice and when the receipt is generated, uncheck the “Show Attendance” box so it does not appear as an attended session on the receipt and send to your client. 
  • Finally, delete the invoice and all duplicate sessions so an account credit is generated for the client and all that remains is the sessions that will be attended by the clients in the future. 
  • You can then mark attendance properly for these sessions and use the account credit to process “payment” for the individual sessions.  

Q: How do I properly set up billing from scratch and start sending invoices and receipts? 

A: It depends on your clinic’s billing practices and whether your clients have billing situations that require more flexibility. If you want everything automated, you can do so through Settings → Payment Details → Basics. This will allow you to set up automatic invoicing creation and sending and the same with payment collection and receipt sending; after attendance is marked, invoices can be automatically generated and emailed for the session, along with payment processing and receipts. If you do have clients that you need more flexibility with, you can adjust their settings specifically by navigating to their client profile → Contact & Clinical → Account Settings.  

Q: I have a client I am seeing pro bono. I have been logging those sessions as “non-billable.” Is that the correct approach? 

A: Like most things with Owl Practice, there are multiple ways to handle this situation! You can still mark those as non-billable if you desire, but another alternative that may allow you to get more detail on the number of pro bono sessions you’re having is to create a new pro bono service. You can configure it in a similar manner that you would any other paid service offered but put “(pro bono)” in the service name and adjust the fee to $0.00. Then you can mark attendance for those sessions according to the true attendance, and then you have a way to track and monitor how many pro bono sessions you’re having and what the general attendance rate is like. 

Q: How do I upload a verification of attendance directly when sending an invoice to specific EFAP providers? 

A: See the question above related to 3^rd party payers and adding them as a Circle of Care contact. You can send the invoice with the attendance included to an EFAP provider that is listed as a Circle of Care contact for your client. 

Additionally, you can download a copy of the invoice and submit it to the EFAP provider directly. 

Q: Why can’t expenses be tracked in OWL alongside client revenue? 

A: Tracking expenses other than bad debt for your clinic in Owl is currently not available. We will bring this to the attention of our Product team for review. 

Q: Can I bill a third-party payor for something like a report that is not tied to a session, but is tied to a specific client? 

A: Yes, you can absolutely do that. First ensure the “Display Payers on Invoices” setting is enabled, and then there are a few ways that you can do so: 

• Default 3^rd Party Payer: If you have specific third parties that you work with for client billing like a specific law office or workers safety board, you can add them as a third-party payer to your account. Go to Settings → Payment Details → 3^rd Party Payers to edit the ones available to add to your clients’ profiles. Once complete, navigate to your client’s profile → Contact & Clinical → Account Details and edit that information. You’ll have the option of setting a Default 3^rd Party Payor, which will then show up as the payor on all of this client’s invoices. 
• Note: If the client already has a Circle of Care contact that is listed as the Default Bill-To when the 3rd Party payer is configured, the Default Bill-To label will be removed, as the 3rd Party payer takes priority. To re-enable the Bill-To, you will need to remove the 3rd Party payer. 
• Circle of Care Contact: If your client is still responsible for the majority of their invoice payments, but there may be a one-off session or Non-Session charge (like a report writing fee) that needs to be billed to a 3^rd party, then you can add that 3^rd party to their Circle of Care. Navigate to the client profile → Contact & Clinical → Circle of Care and Add Contact. From there you should be able to add in the 3^rd Party Payer’s information and set the relationship to 3^rd Party Payer. 
  • Note: do not set them as the default Bill-To, otherwise all invoices generated will have them set as the payer. 
• When the invoice is generated for something like a report writing fee, you can change the payor on the invoice (if payment has not been collected) by using the Split Charges functionality for the invoice.  
• Select the service on the invoice that needs to be split. 
• Then select the 3^rd Party Payer contact as the Payer and attribute the total invoice amount for that service to the payer. 
• Delete the second line item and then split the charge.  
• The 3^rd Party should now show up as the financially responsible party for the invoice. 
  • Note: If a session has already been invoiced prior to a default payer being set, then you will need to utilize the Split Charge functionality to display the newly added payer to the invoice. Moving forward, the default payor should display properly on future invoices. 

Q: Is there a way to prorate fees for clients who are on a reduced or sliding-scale rate? 

A: Yes, there is! There are two types of discounts that can be provided for a client: Global or Service-specific. 

• Global Discount: a percentage off for any service the client may have. 
• Service-specific: a percentage off for a specific service (Psychotherapy, Art Therapy, etc.) that a client may have. 

To add a discount to a specific client, navigate to that client’s profile → Contact & Clinical → Account Details. From there you should be able to edit the section related to Service discounts. If you would like to give the client a global discount for any service, add in that percentage discount there. If you would like to give the client a service-specific discount, click “Add Discount” and select the service you would like the discount to apply to. Moving forward, all applicable services would have discounts applied. 

Q: How do I change a client’s payment method, for example from credit card to e-transfer or vice versa, and resend the invoice or receipt? 

A: This can be done when recording a transaction for the client; you would select the respective payment method that the client would like to use to pay for the session.

Note: only payment methods saved to Stripe can be set as the default payment methods, which could also be used for auto pay transactions.  
 
Additionally, if you need to re-send an invoice or receipt, you can navigate to the client’s profile → Finances and view the receipt and invoices there. When viewing the receipts or invoices, you have the option to send them to your client as well. If you use the client portal, the invoices and receipts should be available for your client to access within their portal at any time. 

Q: Can the system list who attended a session, or who paid, separately from the client name on the invoice? For example, a parent attending a child’s session, where the child remains the client of record but a parent’s insurance coverage may apply. 

A: Yes! First, make sure the “Display Payers on Invoices” setting is enabled, and then there are a few ways to handle this through the Circle of Care. 

• Linked Contact: The most streamlined way of doing to this is to create a client profile for the parent and link it to the child’s profile under their Circle of Care as the Default Bill-To contact. This will allow you to show the client as the main client for the session, but have the parent listed as the payor or responsible financial party. Additionally, this has the added benefit of being able to create sessions where the parent can be listed as an attendee as well. 
• Basic Circle of Care Contact: If you do not want the parent to have their own client profile, then you can still add them to the child’s profile under their Circle of Care as the Default Bill-To contact. This will allow you to show the client as the main client for the session, but have the parent listed as the payor or responsible financial party. However, this does not allow you to have them shown as an attendee for the session. 
• The workaround for showing them as an attendee for the session is to uncheck the “Show Attendance” box for the invoice and then add a note to the invoice for “Attendees” and add the parent there. This will keep the invoice with the client’s information, parent as the payer, and a note on the bottom of the invoice to show the attendees, including the parent. 

Q: Can canceling an appointment be simplified so it does not require going through the invoice first? 

A: Attendance/cancelations are easily marked with on the calendar view or Sessions & Notes section of your client’s profile. When marking attendance, you have 2 options for canceling sessions: Cancel or Late Cancel.  

• A regular canceled appointment does not require an invoice to be generated and that time slot is available to any other client that would like to book a session then.  
• If a specific service has a late cancel fee and your account is set to generate invoices automatically, then an invoice will be automatically generated if Late Cancel is marked for a session. If you need to adjust the session to a different attendance status, then you would need to delete the invoice and then update the session. 

Q: Why is “Card” greyed out under the Accepted Payments section of the Stripe tab? (Payment Details- Stripe- Accepted Payments- Card- No, Bank- available).  

A: By default, Stripe already has card payments enabled. There is not the ability to disable card payments, but you can opt into bank payments. 

Q: How can I reconcile payments?  

A: Within the Dashboard section, there is an area for Data Exports. If you scroll all the way down there is a report for Stripe Payout Transactions that will provide you with the list of transactions, their fees, the corresponding receipt and client IDs, the payout IDs, and payout dates for you to reconcile against.  

Q: How can I see a list of all invoices within the dashboard? 

A: Within the Dashboard section, there is an area for Data Exports. Within the Data Exports there is one specific to invoices that you can download to review the invoices generated for your clinic. 

Q: Can we have the credit show on invoice so if there is a credit and/or an outstanding balance, it automatically shows on invoice and/or receipt? 

A: This option is currently not available as the idea for the invoices and receipts is to have a streamlined document and remove any excess detail that may cause confusion for the client or insurance provider reviewing the document. We can bring this up to the product team for consideration. 

Build a Billing Workflow That Works for You

No two practices bill exactly the same way. Whether you’re managing third-party payors, offering sliding-scale rates, billing in advance, or tracking pro bono services, having flexible billing tools can help you create a workflow that supports both your clients and your administrative needs.

As your practice grows and evolves, Owl Practice gives you the flexibility to adapt your billing processes without adding unnecessary complexity. From payment collection and reporting to discounts and custom billing scenarios, the right setup can help you spend less time on administration and more time delivering care.

If you missed the webinar, or would to rewatch it at your convenience, you can find the “Mastering Client Billing with Integrated Payments” session here.

Not using Owl Practice? Start a free 14-day trial today or book a demo with one of our experts to see how Owl Practice simplifies invoicing, payment tracking, refunds, and financial recordkeeping for private practices.