BlueFinch Advisors ยท Working worksheet
Cash-pay physical therapy: reconcile estimates, visits and payments
Version 2026-09-07. Keep private details in your own records. This worksheet does not send information to BlueFinch.
Use your browser's Print command to print this sheet or save a PDF. Prefer a spreadsheet? Download the CSV worksheet. On a small screen, swipe across the table to see every column.
Use the printable estimate-to-payment worksheet
Try the worksheet with a practice account reference rather than patient details. Store completed patient records in your approved system, and check actual receipts before explaining a balance.
| Account record | Count / amount | Date / reference |
|---|---|---|
| Current estimate version | ________________ | ________________ |
| Expected services and charges | $_______________ | ________________ |
| Package visits purchased | ________________ | ________________ |
| Visits delivered | ________________ | ________________ |
| Payments received | $_______________ | ________________ |
| Approved change or credit | $_______________ | ________________ |
| Refund issued | $_______________ | ________________ |
| Unused visits / prepaid allocation | ________________ | ________________ |
| Receipt or superbill provided | ________________ | ________________ |