Use this article to turn on automatic payments in Upheal, enroll clients with their consent, and manage the Automatic charges queue. With automatic payments, you no longer have to chase session fees or no-show fees after sessions.
Automatic payments are available on our EHR plans: EHR, EHR Pro, and the former Premium plan.
Automatic payments require a connected Stripe account in Upheal. See Setting up a Stripe account.
How automatic payments work
Automatic payments charge a client’s saved card after each session, so you don’t have to send invoices or follow up on unpaid sessions. Automatic payments always start with the client’s consent:
The client opts in by signing the Automatic payment authorization form and confirming a card. Upheal never charges a client who hasn’t signed the form.
When signing, the client can choose to get an email notice 10 days before each charge. If they select this option, late cancellation and no-show fees are invoiced instead of charged.
The client can withdraw their authorization at any time in the Client Portal.
Once a client is enrolled, Upheal creates the invoice after each session and charges the remaining balance to the client’s card on file. Stripe emails the client a receipt for each charge.
What automatic payments charge
Automatic payments can charge the following amounts to an enrolled client’s saved card:
Self-pay clients: the session fee.
Insured clients: the copay.
Late cancellation and no-show fees: see Late cancellation fees and appointment status.
Note: A balance that remains after insurance pays is never charged automatically. Automatic payments wait for the insurance payment report and then ask you to approve the client’s remaining balance before anything is charged. See “Approving a client’s balance after insurance” below.
Who has permission to manage automatic payments
What you can do with automatic payments depends on your Upheal role. The table below shows what each role can do:
Role | Practice-wide settings | Clients and charges | Automatic charges queue |
Admin, Practice Manager, Biller | Can change | All clients | All clients |
Provider | Can’t change | Own clients only | Own clients only |
Practice-wide settings cover turning automatic payments on or off, when charges run, the limit per charge, and the nightly summary email. Clients and charges covers sending the authorization form, setting the billing method, asking for a card, revoking, and removing or approving charges.
Turning on automatic payments for your practice
To turn on automatic payments for your Upheal practice, go to your Billing settings. You only do this once for the whole practice. After that, you enroll each client individually.
Go to Settings in the left menu.
Select Billing settings.
Scroll down to the Automatic payments section and switch on Charge automatically.
Click Turn on.
Set the limit per charge by selecting Match highest service price or Custom amount. See Setting a limit per charge below.
Use the dropdown menu next to When to charge to choose when charges run: After the session ends or After the note is signed. See Choosing when automatic charges run below.
Use the dropdown menus under Nightly summary email to choose the time the email is delivered and to which recipients, or, you can switch summary emails off.
The nightly summary includes the charges scheduled for that night, charges that need attention, and charges that failed.
⚠️ Review the Automatic charges queue right after turning on automatic payments. Turning on automatic payments adds sessions from the last 2 days for clients who are already enrolled. Go to Payments > Automatic charges and remove anything you don’t want charged before the charges run.
Automatic payments are now on for your practice. Clients are only charged once they’re enrolled, so the next step is to send each client the authorization form.
Choosing when automatic charges run
Automatic payments can charge a client at one of two points after a session. You choose the timing for the whole practice under Payments > Billing settings > Automatic payments:
After the session ends: the client is charged at midnight in the provider’s time zone after the session.
After the note is signed: the client is charged as soon as the session note is signed. Sessions without a signed note are never charged.
Note: If you choose After the note is signed, unsigned session notes block automatic payments. A session isn’t charged until its note is signed.
Setting a limit per charge
The limit per charge is the highest amount automatic payments can charge a client in a single charge. It protects clients from unexpected amounts. Set the Limit per charge to one of these options:
Match highest service price: the limit equals your practice’s highest service price. This is the default.
A custom amount that you enter.
The client agrees to this limit when they sign the authorization form. You can’t send the Automatic payment authorization form until at least one service has a price or you’ve set a custom limit.
Note: Automatic payments never charge more than the limit the client signed. A charge above the limit isn’t charged automatically. It waits in the Needs attention tab of the Automatic charges queue (found in Payments in the left menu) for you to review.
Enrolling a client in automatic payments
To enroll a client in automatic payments, send them the Automatic payment authorization form. The client is enrolled once they sign the form and confirm a card. You can send the form from any of these places:
The client’s profile: Edit client > Billing tab > Automatic payments.
The Forms tab.
Intake, as part of the forms the client completes when they join.
To send the Automatic payment authorization form from a client’s profile:
Go to Clients in the left menu.
Click the client you want to send the Automatic payment authorization form to.
Click Edit on the right.
Select the Billing tab.
In the Automatic payments section, click Send authorization form.
The client receives the form, signs it, and confirms a card. When signing, the client can choose to get an email notice before each charge. Once the client has signed, their sessions are charged automatically.
Which client billing methods charge automatically
Each Upheal client has a billing method. Only Card on file charges the client automatically. The billing methods are:
Card on file: automatic payments charge the client’s saved card after each session.
Payment link: the client pays through a link. Not charged automatically.
Billed outside Upheal: you bill the client outside Upheal. Not charged automatically.
Don’t bill: the client isn’t billed.
Managing the Automatic charges queue
The Automatic charges queue shows every automatic payment, from scheduled charges to completed ones. To open it, go to Payments > Automatic charges.
Each row has a menu that lets you remove the charge from the queue or resolve it.
The table below explains each tab in the Automatic charges queue:
Tab | What it shows |
Scheduled | Charges that will run at the next scheduled time. You can remove a scheduled charge before it runs. |
Waiting | Charges waiting on something before they can run, such as an insurance payment report or a card from the client. |
Needs attention | Charges that can’t run until you fix something, such as an unknown copay, a service without a price, or an amount above the client’s limit per charge. |
Needs approval | Balances a client still owes after insurance paid. These are only charged once you approve them. |
History | Charges that have finished, including successful charges, charges covered by credit, and charges marked Not charged. |
Removing a scheduled automatic charge
To stop a scheduled automatic charge before it runs, remove it from the Automatic charges queue:
Go to Payments in the left menu.
Select the Automatic charges tab.
Select the Scheduled tab.
Click the three-dot icon on the charge’s row and click Remove from autocharge queue.
Optionally, add a note detailing why the charge is being removed.
Click Remove.
The charge won’t run. The invoice stays open, so you can still charge it manually or send it to the client.
Approving a client’s balance after insurance
For insured clients, automatic payments charge the copay after the session. Any balance the client still owes after insurance pays needs your approval before it’s charged. Here’s how it works:
The charge for the remaining balance sits in the Waiting tab until the insurance payment report, called an ERA (electronic remittance advice), arrives.
Once insurance has settled and the client owes more, the charge moves to the Needs approval tab.
Review the amount and approve it from the charge's row by clicking Approve.
To confirm, click Approve again in the confirmation window.
The card on file is charged that night at midnight, and the client sees the updated invoice right away.
Balances after insurance are never charged without your approval.
Resolving charges in Needs attention
An automatic charge moves to the Needs attention tab when Upheal can’t work out what to charge. Common reasons are:
The client’s copay is unknown.
The session’s service has no price.
The amount is above the limit per charge the client signed.
To resolve a charge in Needs attention:
Go to Payments > Automatic charges > Needs attention.
Click the three-dot icon on the charge’s row and click Resolve. This opens the session, billing settings, or the billing tab of the client's profile, depending on the information that needs to be filled in.
Fix the cause, for example, by adding the client's copay or setting a price for the service.
What happens when a client’s card is declined
If a client’s card is declined or the card isn’t confirmed, the automatic charge moves to Waiting for card. Upheal emails the client to add or confirm a card.
Automatic payments try each charge up to 3 times.
After 3 failed attempts, the charge shows Not charged and the invoice stays open.
You can charge an open invoice manually or send it to the client.
When client credit covers a session
If a client has enough credit on their account to cover the amount, automatic payments don’t charge their card. The charge shows Covered by credit in the Automatic charges queue.
Revoking automatic payments for a client
To stop automatic payments for one client, pause or revoke them from the client’s profile:
Go to Clients in the left menu.
Click the client.
Click Edit.
Go to the Billing tab.
In the Automatic payments section, click Revoke.
Open invoices stay open and can be charged manually.
Clients can also withdraw their authorization themselves in the Client Portal. When a client withdraws, automatic payments stop for that client.
Turning off automatic payments for your practice
To turn off automatic payments for your whole Upheal practice, go to Settings > Billing settings > Automatic payments and turn off Charge automatically.
Turning off automatic payments removes tonight’s scheduled charges. Open invoices stay open, and you can charge them manually.