Billing and payments

Billing and payments

Mediyn’s billing features cover the full financial workflow for therapists and clinic administrators: storing patient payment methods, generating compliant clinical documents, managing invoices and session packages, tracking Good Faith Estimates, and administering your own Mediyn subscription. The sections below describe each area of functionality currently available in the platform.

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Insurance Eligibility

• Therapists can verify a patient’s insurance eligibility directly from the Billing section without leaving the billing workflow.
• Select a patient, run an on-demand check, and immediately see coverage status, copay, deductible remaining, and payer details.
• If the payer returns an error, a clear message is displayed.
• Eligibility checks also continue to be available from the patient insurance card and the new-session dialog.

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Superbills

Creating and Editing

• Superbills can be created from any fully approved session using ICD-10 diagnosis codes and CPT procedure codes.
• Superbills can only be generated for sessions that have been fully approved; attempting to create one for a session that is still in progress or not yet approved returns a clear error.
• CPT procedure codes, modifiers, and place-of-service values can be added, edited, or removed directly from a completed session’s superbill review without navigating to the Billing section. Multiple service lines are supported. Changes save automatically and are reflected everywhere superbills appear in Mediyn.
• Draft superbills can be edited — including diagnosis codes, procedure codes, and billed amounts — before they are finalized.
• A Delete option is available on any draft superbill not yet finalized. The Void option is reserved for superbills that have already been finalized or sent.
• Before a superbill can be finalized, all required fields — including diagnosis codes, procedure code, session date, and provider credentials — must be complete. Any missing items are flagged individually with inline guidance. If your provider profile is incomplete, a prompt takes you directly to the relevant settings to resolve it.
• Superbills cannot be finalized with missing billing information or incomplete provider credentials.

Previewing and Finalizing

• Therapists can preview a superbill as a rendered PDF before finalizing it. Use the preview option on any draft superbill to check formatting and content — no notification is sent and the superbill status does not change. Preview links are active for 5 minutes.
• In the superbill creation and edit flow, click “Preview & finalize” to see exactly how the document will look before confirming. If changes are needed, return to the form without voiding or recreating the superbill.

Telehealth Superbills

• When a superbill is created from a telehealth or virtual session, the correct CMS-1500 place-of-service code and telehealth modifier 95 are filled in automatically, though both can be adjusted before finalizing.

Amending Finalized Superbills

• Therapists can amend a finalized superbill directly without voiding it first.
• The corrected version is created as a new draft that can be reviewed and finalized. The original is automatically marked as amended and remains accessible for reference.
• Patients always see the latest version of their superbill, with a clear disclosure indicating when and that a correction was made.

Sending and Downloading

• A finalized superbill can be emailed directly to a patient with a single click from the superbill detail view or the superbills list. The email includes a secure download link valid for 30 days and a link to the patient portal.
• After sending, the superbill record shows when it was last sent and how many times it has been delivered. Superbills can be resent at any time.
• Patients automatically receive a notification and email when a therapist finalizes a superbill, including the service date and billed amount. Therapists can also manually resend the notification from the superbill detail view.
• Patients can manage this notification preference in their portal notification settings.

Superbill PDF Format

• Superbill PDFs render as a complete CMS-1500-style document with all standard numbered fields, a structured boxed layout, and the full subscriber/insurance block for insured patients.
• Superbills with multiple service lines show one row per line, each with its own procedure code, modifiers, diagnosis pointers, units, and charge.
• Patient date of birth and sex are reliably populated on the rendered PDF when that information is on file.

Consolidated Superbill Statements

• Therapists can generate a single consolidated superbill statement covering all sessions within a chosen date range for a patient, rather than one document per session.
• Use the “Generate Statement” option on the patient billing tab, select the date range, and download the PDF. The statement lists each service date, procedure code, and diagnosis alongside a totals summary, formatted for submission to an insurance carrier.
• Once finalized, patients can view and download the statement directly from their portal.

Superbill List and Navigation

• The superbills list loads in pages of 20, with previous and next navigation controls, keeping the view fast and responsive as records grow.
• The superbills list displays ICD-10 diagnosis codes that were submitted, directly in the app — no need to download the PDF to find this information.
• The notification for superbills awaiting review displays as a slim, full-width bar at the top of the billing section, with the draft count and a direct link to review them.
• Invoice and superbill screens display patient and therapist names directly in list views and individual record details.

NPI Validation

• Mediyn validates the NPI entered in a therapist profile against the CMS checksum algorithm when saving. If the NPI fails the checksum, an inline error is shown and the save is blocked until corrected.
• Superbill generation also performs this check on the backend. If the stored NPI is incorrectly formatted, you will be prompted to correct it in your profile before the superbill can be finalized.

Known Issue

• Some finalized superbills may display “Not provided” for patient date of birth, address, and insurance information even when the patient’s profile is complete. This is a known issue affecting superbills created via certain workflows. No action is required from users at this time.

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Good Faith Estimates

Creating and Sending

• Therapists can create and manage Good Faith Estimates directly from a patient’s profile under the Billing tab, or from the intake records tab.
• Each estimate captures provider details, diagnosis codes, a valid date range, and itemized service lines with an auto-calculated total.
• Diagnosis and procedure codes are selected from a searchable ICD-10 and CPT list rather than entered as free text.
• GFEs default to a 12-month coverage period and expire automatically when that period ends.
• Therapists can send a Good Faith Estimate directly to a patient from the billing or intake tab. The patient receives an email with a PDF of their cost estimate and a link to review and acknowledge it.
• Patients who do not yet have a portal account can acknowledge their estimate through a secure one-time link without needing to create an account.
• Both therapists and patients can download the GFE PDF at any point after it has been sent.

GFE Lifecycle and Status

• Estimates follow a clear status lifecycle — Draft, Sent, Acknowledged, and Expired — visible in the billing tab as soon as a GFE is created.
• Therapists can edit a GFE while it is still in draft, resend it to a patient who has not yet acknowledged it, and issue a revised estimate when a treatment plan changes. The previous version is automatically superseded and preserved for records.
• Voiding a GFE requires entering a reason so that records remain audit-ready.
• GFEs that have passed their validity period are automatically marked as expired.
• Therapists and patients receive a reminder notification approximately 14 days before a GFE expires.

Automatic Reminders and Dashboard

• Patients who have not acknowledged a sent estimate receive automatic reminder notifications at 3, 7, and 14 days.
• A dashboard card shows how many GFEs have been sent but not yet acknowledged, and surfaces unresolved estimates for follow-up.
• The GFE detail view displays a full status timeline with timestamps.
• The GFE compliance dashboard accurately shows all self-pay and uninsured sessions that are missing a delivered GFE, including sessions where only an unsent draft exists.

GFE Content and Compliance

• Good Faith Estimates include all federally required fields: diagnosis and procedure codes with plain-language descriptions, place of service, and an automatically attached patient rights notice.
• GFEs include a full itemized breakdown of services — procedure descriptions, quantities, and per-line costs — as required under the No Surprises Act.
• Therapists can view the complete history of GFEs sent to a patient and check acknowledgement status.
• Patients see a clear “Right to receive a Good Faith Estimate” notice during intake and in the patient portal, in line with No Surprises Act requirements.
• Patients can request an updated cost estimate at any time directly from their portal, and their therapist is notified promptly.
• When an invoice is more than $400 above a patient’s Good Faith Estimate, both the patient and therapist automatically receive a clear disclosure of dispute-resolution rights.
• When creating an invoice, a warning appears if the amount exceeds the patient’s acknowledged GFE by $400 or more, giving the opportunity to issue a revised GFE first.

GFE Workflow Prompts

• After scheduling a self-pay or uninsured appointment, a prompt appears to generate a Good Faith Estimate directly from the patient’s billing tab.
• Mediyn automatically generates a Good Faith Estimate draft whenever a self-pay or uninsured patient session is booked three or more business days in advance. A dashboard card shows any sessions where a GFE needs attention before the federal delivery deadline.
• Creating a Good Faith Estimate is a deliberate step in the intake or billing workflow; scheduling a session no longer creates a draft GFE automatically.
• A GFE PDF can be downloaded directly from the intake page without opening the full detail view.

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Invoices

Creating and Managing Invoices

• Invoices are automatically created when a session is approved, subject to your auto-invoice settings. Clinics that have explicitly set auto-invoice to off are not affected.
• A Create Invoice action is available for billing late-cancellation fees, administrative charges, or any charge not tied to a specific session. Manual invoices start in pending status and follow the same payment workflow as session-generated invoices.
• When creating an invoice, a session can be linked to it directly from the create invoice form.
• Therapists and clinic admins can retry a failed payment directly from the invoice without voiding and re-creating it.
• The invoice list includes a Draft tab for filtering invoices created but not yet sent. Draft invoices display with a clear status badge.
• The invoices page displays a clear alert when any invoice has a failed payment, making it easier to follow up and retry collection.

Invoice Content and Display

• Invoices include the session type, provider name, and service date directly in the invoice description and list view — for example, “50-Minute Individual — Dr. Sarah Mitchell (Apr 1, 2026)”.
• Invoices include the clinic name, address, contact details, provider credentials, itemized line entries with CPT codes and service dates, and a sequential invoice number.
• Invoice detail pages correctly display the billing provider name, clinic information, and patient name immediately after an invoice is created. These details are captured at the time the invoice is issued and remain accurate on historical invoices even if contact information changes.
• Invoice and superbill lists display patient and therapist names directly rather than internal identifiers.
• When viewing an invoice, a full itemized breakdown of charges is shown when one has been generated for a session.
• Invoice totals display correctly; a previous issue where the Total column could show “$NaN” has been resolved.
• Invoices created before display updates retain their original descriptions.
• You can search invoice history by provider name.

Automatic Charging

• When automatic billing is enabled, invoices are charged to the patient’s card on file as soon as a session is approved — no manual action required.
• If a patient has no payment method on file, the invoice is immediately marked as payment failed so the team can follow up.
• Successfully charged invoices are updated to paid in real time.

Invoice PDFs

• Therapists and clinic staff can download a professionally formatted PDF for any invoice directly from the admin portal.
• Patients can download invoice PDFs from the patient portal.
• The PDF includes clinic branding, itemized service details with CPT codes, provider information, and payment status.

Patient Payment via Portal

• Patients can pay outstanding invoices directly from the patient portal using a saved payment method. The invoice status updates in real time as the transaction is processed.
• If no payment method is on file, the portal prompts the patient to add one before proceeding.

Payment Receipts

• A dedicated Payment Receipt is available for download from any paid invoice in the admin portal and the patient portal.
• The receipt shows the payment date, card used, transaction reference, provider NPI, CPT codes, and a PAID confirmation — suitable for HSA/FSA reimbursement, IRS medical-expense records, and out-of-network insurance claims.
• The receipt is stored separately from the invoice so both documents remain available independently. Download links are time-limited for security.

Account Statements

• Therapists can generate a date-range account statement as a downloadable PDF from the patient billing tab.
• Patients can download their own statement from the invoices section of the patient portal.
• Statements include an itemized list of charges, payments, and running balance — with columns for Date, Description, Charges, Payments, and Balance — along with footer totals for Total Charges, Total Payments, and Outstanding Balance.

Billing Preferences

• The Billing Preferences page shows only fully supported settings: Automatic Invoicing, Auto-Charge Patients, and Automatic Superbills.
• The Payment Terms, Late Fee, and Tax Rate fields have been removed from Billing Preferences because they were not connected to invoice generation.
• Per-invoice tax rate can still be set when creating an invoice manually.
• Clinic administrators can set invoice due days, late fee percentages, and tax rates from the Billing Settings page.

Fee Breakdown on Paid Invoices

• When a Stripe Connect payout account is connected, paid invoices show a full fee breakdown in the invoice detail view: the session total charged to the client, the Mediyn platform fee, and the net amount received. This breakdown is available for every paid session linked to a connected Stripe account.
• When a patient pays for a session through the patient portal, the therapist can view the full session amount charged, the Mediyn platform fee (10%), and the net amount deposited.

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Cancellation and No-Show Fees

Policy Configuration

• The cancellation policy settings page reflects a single active policy at a time. Create or edit the policy to set the notice window and late-cancellation fee.
• Patients see the exact fee and notice requirement in the cancellation dialog before confirming.
• Fee calculations are consistent whether a session is cancelled by the patient or by the therapist.

Automatic Fee Collection

• When a patient cancels within the late-cancellation window, any applicable fee is automatically charged to the card on file. If the session was prepaid, a refund is issued to the card at the time of cancellation.
• A confirmation message immediately after cancellation states exactly what was charged or refunded. If a charge is declined, an email is sent with a direct link to retry payment from the Invoices page.
• When a patient cancels late or misses a session, any configured cancellation or no-show fee is charged automatically to their saved payment method — no manual action required.
• Therapists receive an email notification whenever a patient cancels a session, in addition to the existing in-app alert.

Fee Waiver

• Therapists can waive a late-cancellation or no-show fee directly in the cancel or no-show dialog using a checkbox, without any additional steps in the billing section. The confirmation message confirms when no fee has been applied.

Therapist-Initiated Cancellations

• When a therapist or clinic admin cancels a session, patients do not receive a late-cancellation fee invoice or fee notification email, even if the cancellation occurs within the policy’s notice window.

Booking-Page Refunds

• When a session booked and paid through the online booking page is cancelled or marked as a no-show, refunds are handled automatically according to the practice’s cancellation policy. Patients who cancel within the allowed notice window receive a full refund; patients who cancel late receive a partial refund with the applicable cancellation fee withheld. Sessions cancelled by the clinic always result in a full refund.

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Session Packages

Assigning and Purchasing Packages

• Therapists can assign a session package to a patient from the Billing → Packages page without navigating to an individual patient record. Select the patient from the active-patient list, choose a package template, and complete payment — the assigned package appears in the Active Patient Packages list immediately. The existing assign workflow on each patient’s Billing tab is unchanged.
• When assigning a package, therapists are prompted to collect payment before the package becomes active. If the patient has a card on file, it can be charged directly from the assignment dialog. If no card is on file, a payment form appears inline. A dedicated toggle allows a package to be marked as complimentary at no charge.
• Packages remain in a pending status until payment is successfully processed. Once payment is confirmed, the package activates automatically.
• Therapists can also send a session package directly to patients for self-service payment. The patient receives a notification in their portal with package details and a prompt to pay using their own card, with the package activating automatically once payment is confirmed.
• Cards saved during a package purchase are reused for future bookings automatically without re-entering payment details.
• Session package assignments are visible for clinics with up to 200 patients on the packages page. Previously, only the first 50 patients appeared. If your clinic has more than 200 patients, some assignments may still not appear — a more comprehensive solution is planned for a future update.

Package Display and Naming

• Session packages display the name set on the original package template (for example, “10-Session Bundle”) throughout the platform — in the billing dashboard, patient billing tab, and patient portal.
• Packages created before this update will show a previous fallback name or blank name, which can be updated going forward.
• Patients can see the full package price and session type on their packages page before clicking Pay Now.

Package Validity and Expiry

• Clinic admins can set an optional validity window on package templates (for example, 12 months or 90 days). Purchased packages display a clear expiry date alongside a description of what is covered.
• Patients receive a notification 30 days before a package expires and again when it transitions to expired.
• Therapists and clinic admins can extend a package at any time — including reactivating an expired one — directly from the platform.

Cancellations and No-Shows with Packages

• If a therapist cancels an appointment, the session is automatically returned to the patient’s package balance.
• For late cancellations or no-shows by the patient, the clinic’s cancellation policy determines whether a session is deducted from the package or a no-show fee is charged — not both.
• Therapists and patients see a clear explanation of which action will be taken before confirming a cancellation.
• When a session linked to a package is marked as a no-show, the package session count is correctly reduced. Packages automatically close out once all allocated sessions have been used or no-showed.

Package Integrity

• Mediyn enforces that a session can only be linked to a package that has been paid and still has available sessions remaining. If a package is unpaid, fully used, or no longer active, the booking is declined with a clear error.

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Payment Methods and Stripe Connect

Patient Payment Methods

• Patients can add a payment card from the dashboard. When no payment method is on file, clicking Add Card opens the card entry form immediately.
• After adding a payment card, the payment profile displays the card brand and last four digits.
• The Billing Settings page correctly shows saved card details — including card brand and last four digits — when a payment method is on file.
• The Payment Methods page shows a “Card setup in progress” message for any payment profile not yet fully activated.
• When adding a payment card fails, a plain-language message explains what went wrong (for example, that a card was declined or has expired) and includes guidance on what to do next.
• Invoice payments complete successfully even when Stripe webhook delivery is delayed. If a saved card was not yet confirmed at the time of payment, the platform automatically verifies the card status with Stripe and activates it as part of the payment flow.

Stripe Connect for Therapists and Clinics

• Therapists and clinic admins can connect a Stripe account from Settings → Payments to receive direct patient payments.
• Stripe Connect onboarding is available for all account types, including solo therapist (THERAPIST-mode) accounts.
• Once connected, the Payments page displays the active account status and removes the setup prompt.
• After completing onboarding, payouts are deposited on a rolling schedule. Payout status, balance, and tax documents are accessible from Settings > Billing.
• If you prefer not to connect right away, Mediyn continues to collect payments on your behalf until you’re ready.
• The Stripe Express Dashboard is accessible from Mediyn admin settings for payout history, tax forms, and bank details.

Stripe Onboarding Status Messaging

• During bank account setup, the billing dashboard shows messaging tailored to where you are in the process: a prompt to continue if setup was started but not finished, or a confirmation that your information is under review if all details have been submitted.
• If your account verification is still in progress, or if Stripe requires additional information to keep payouts active, you will see an actionable prompt with a direct link to resolve it.
• A billing setup card on the dashboard guides you through connecting your bank account, enabling automatic invoicing, and creating your first invoice. The card tracks progress and disappears automatically once all three steps are complete.

Booking Page and Payment Setup

• The booking page shows a neutral message when a clinic has not yet completed payment setup, rather than a broken payment form. Once Stripe Connect onboarding is complete, card payment collection through the booking flow becomes available automatically.

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Subscription and Plan Management

Subscribing and Upgrading

• Mediyn includes a complete billing and subscription management experience. Therapists and clinic admins can compare plans, subscribe or upgrade directly in the app, and manage their payment method and billing history without leaving the platform.
• When you try to access a feature that requires a higher plan, you see a focused upgrade screen showing only the relevant plan options, your proration cost, and — if needed — a payment method form, all without leaving the page you were on. After completing the upgrade, you are returned directly to the feature you wanted to use.
• If you are considering downgrading, the flow lists exactly which features would be removed before you confirm.
• Clinic plan pricing correctly shows both the monthly platform fee and the per-seat fee at checkout, with the total reflecting the number of provider seats selected. Seat counts adjust automatically — with prorated billing — when therapists are added or removed.

Subscription Management Page

• Clinic admins can access a subscription management page via the sidebar Manage Billing link. The page shows the current plan status, the number of therapist seats purchased versus in use, and a monthly cost breakdown. Seats can be added or removed directly from the page, with a live cost preview before confirming changes.

Free Trial

• Starting a Mediyn trial requires adding a payment method at signup. No charge is made during the 14-day free trial. If you cancel before the trial ends, your card is never charged. At the end of the trial, your chosen plan is billed automatically.
• During the trial, a countdown in the app shows how many days remain. Starting three days before the trial ends, a banner reminds you of your upcoming plan and charge date. You can cancel at any time from billing settings.

Subscription Status and Access

• Mediyn enforces subscription status across all product features. When a trial ends or a subscription lapses, access is paused until a plan is activated or renewed — subscription and billing management pages remain available throughout.
• Accounts with a failed payment receive a 7-day grace period with an in-app warning before access is restricted.
• If a Mediyn subscription has a payment issue, a warning banner appears at the top of the dashboard on every visit until the payment method is resolved.
• A notification in the notification bell prompts you to update payment details when a payment fails or a payment method is missing. Clicking the notification takes you directly to billing settings.
• When all account administrators and therapists in a clinic have a subscription payment fail, they receive an in-app notification. If the payment is retried successfully, the subscription automatically returns to active status.
• When a payment method is removed and a renewal is due, clinic account owners receive a notification alerting them to the payment issue. Once a valid payment method is added and the payment succeeds, the subscription is automatically restored to active status.
• A “Go to Billing” button and a “View Plans” link are available from the subscription expiry message to help resolve access issues.

Reactivating a Subscription

• If a subscription has been cancelled but the period has not yet ended, a “Reactivate Subscription” button appears in billing settings. Clicking it and confirming continues the subscription uninterrupted.

Onboarding

• After completing subscription sign-up, you are taken directly into a guided setup wizard to connect your bank account via Stripe.
• Solo therapist accounts see the billing setup step at the start of onboarding, the same as clinic admin accounts. The step can be skipped and returned to later — reminder emails are sent to help complete billing setup.
• The onboarding setup flow includes fields for NPI, tax ID, license number, license state, taxonomy code, and professional credentials, so therapists can complete billing setup in one place during initial configuration.
• If a therapist’s taxonomy code has not been entered, submitting a claim in clinic billing mode returns a clear error identifying the missing field. Existing taxonomy and NPI information already on a therapist’s profile is never overwritten by a partial update.
• After completing subscription sign-up, the billing settings page displays the actual card on file — including card type, last four digits, and expiration date.
• Signing up now takes you directly into onboarding without an extra login step after payment.
• Signing in to a different account in the same browser tab always loads the correct plan and feature access for that account.

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Provider Onboarding and Profile Fields

• The onboarding setup flow includes fields for NPI, tax ID, license number, license state, taxonomy code, and professional credentials.
• Clinic administrators can update their business information — including address, phone, billing email, and tax ID — from the admin settings area.