`Monthly billing checklist for pediatric OT and SLP practices`

A practical review for solo private-pay practices

By Therativities

A monthly billing review checks that completed sessions have the correct charges, recorded payments match the evidence, open balances have a next step, and family documents reflect the right services and amounts. Work through those checks before preparing superbills, then carry unresolved items into a dated follow-up list.

Use this checklist if you run a small pediatric occupational therapy or speech-language pathology practice and handle your own billing. It works alongside your regular invoicing routine. Insurance claim submission, coding decisions, and your accounting close may need separate review with the appropriate professional.

Before you start

Choose the month you are reviewing and write down the date of the review. Keep service dates and payment dates separate: a September session may be paid in October. Open the records you already use for appointments, invoices, payments, refunds, and family documents.

Use your approved practice system for identifiable client details. Keep a general checklist free of names, diagnoses, and payment information.
Have your current fees and agreed payment terms available so you can check exceptions against the actual arrangement.

1 Check which sessions actually happened

Review each appointment in the month. Confirm whether it was completed, canceled, rescheduled, or missed. A recurring calendar entry alone does not establish that a session took place.

For completed visits, check the client, date, clinician, and service record. Resolve missing or conflicting details before using them to prepare billing documents. If siblings attend your practice, check each child’s record separately even when the same adult pays.

Keep cancellation or missed-appointment fees distinct from completed therapy services. Review any proposed fee against your practice policy and applicable requirements; do not describe an unperformed visit as delivered treatment.

2 Match completed sessions to charges

Compare the completed-session list with your invoices or charge records. Look for a visit that has no charge, a charge entered twice, or a fee that differs from the agreement in place for that family.

Check that a rescheduled visit was not billed on both dates. If a charge was changed, keep the reason and the supporting record. Put unclear items on your follow-up list rather than making an unexplained adjustment to balance the month.

3 Match payments to the right records

For every payment you record, check the amount, date, payment reference, and the invoice or services it covers. Include payments received outside your card processor, using the records you keep for those methods. Check refunds and credits separately so they are not mistaken for new payments.

If one payment covers several visits, make the allocation clear in the client’s billing record. If a parent pays for two children together, confirm how much belongs to each child before preparing either child’s documents.

Also distinguish a client payment from the processor’s payout to your bank. For example, a payment collected near month-end may reach the bank in the next month. Fees, refunds, and other adjustments can affect the payout total.

Stripe explains payout timing and provides a breakdown of transactions within automatic payouts. Use your own processor’s records to investigate a difference before treating it as unpaid client debt.

4 Give each open balance a next step

Review outstanding invoices against the payment terms you agreed with the family. Check for a payment that has arrived but has not yet been recorded, an unresolved correction, or an agreed payment arrangement before contacting anyone.

For each remaining item, record the amount, why it is open, the next action, and the date you will check it again. Keep this list inside your approved practice records. If you send a routine payment reminder, use the authorized billing contact and your established communication process.

A useful next action is specific: “Check whether the transfer cleared on October 3” or “Review the disputed invoice with the billing contact.” “Follow up later” leaves the same question for next month.

5 Review the documents families need

Decide which families need an invoice, receipt, or superbill under your established process. An invoice requests payment. A receipt records payment. A superbill itemizes services and includes information that a family may use when submitting an insurance claim.

For a fuller explanation, read superbill vs invoice vs receipt.

Before preparing a superbill, compare its client, provider, service dates, charges, and payment details with the source records. Use diagnosis and procedure codes supported by the clinical documentation, with payer-specific requirements checked by someone qualified to do so. Do not choose a code solely because a template suggests it.

ASHA’s superbill guidance notes that a template does not imply payer coverage and may not contain every item a payer requires. A complete-looking document does not guarantee reimbursement.

6 Record what you sent and what remains

Before sharing a family’s document, verify the recipient, the child’s identity, the date range, and the attachment itself. Use your practice’s approved delivery method. Save the final version and record when it was sent so you can distinguish it from an earlier draft.

If a correction is needed later, preserve the history and identify the corrected version according to your recordkeeping process. Check the insurer’s instructions before a family resubmits a claim; do not assume a second submission will replace the first.

Finish by reviewing the open-item list. Give every unresolved item a next action and a review date. Your month-end review can be documented as complete while specific exceptions remain open and visible.

Your reusable month end checklist

Appointment statuses checked against what actually happened
Completed visits matched to the correct charges
Duplicate, missing, and changed charges investigated
Payments, refunds, and credits matched to supporting records
Open balances reviewed before reminders are sent
Family documents checked and final versions recorded
Unresolved items assigned a next action and review date

Questions about monthly therapy billing

Should I wait until month-end to bill families?

Follow the payment timing you agreed with each family. A monthly review is a separate check on your records; it can sit alongside billing after each session, weekly invoicing, or another agreed schedule.

Should every family receive a monthly superbill?

Use the cadence your practice and the family have agreed on, with the health plan’s requirements and submission deadline checked where relevant. Do not assume that one monthly schedule works for every plan or family.

Can I complete this review without practice management software?

Yes. The review is a process for checking your existing records. Use systems appropriate for your practice’s privacy and recordkeeping requirements, and keep a clear link between each appointment, charge, payment, and document.

Ready to prepare a superbill

Once you have checked the source records, open the Therativities superbill form. It includes provider, client, diagnosis, service, and payment fields. Review the information carefully and confirm the family’s plan requirements before using a superbill for a claim.

Open the free superbill tool