Prepaid Therapy Sessions with Session Credits and Packages

The problem: revenue slipping away between sessions

In a cash-pay practice, the session happens first and the money often comes later. Clients forget to pay, cards decline, and packages sold on paper are tracked in a spreadsheet nobody updates. At the end of the month someone has to work out who still owes what, and every one of those conversations is awkward for a therapist who has to sit across from the same client next week.

No-shows and late cancellations make it worse. Without a balance to draw from, a cancellation policy is something you have to enforce by invoice, so most practices quietly let it go.

Prexella's fix is prepaid session credits: clients pay first, card checkout happens at booking, and low-credit reminders go out without you writing them.

How Prexella's prepaid therapy sessions work

Credits are a running balance on each client's account, kept as a ledger rather than a single number, so every change has a reason and a date.

1. Clients buy credits. In the client portal, clients buy a single session's worth of credits or a multi-session package and pay by card. New clients can also pay by card when they first book on your online booking page.
2. Booking draws from the balance. When a client books in the portal, the session's credit cost is deducted. If the balance does not cover the session, the portal asks them to buy credits first, so a session is never booked unpaid.
3. Everyone sees the same numbers. Clients see their balance and history in the portal. Staff see every client's balance in the Patient Credits tab, with credits left, credits used and the full history.
4. Staff can record offline payments. Cash or a check taken in the office is recorded against the client, which adds the credits and logs the payment.

Emails that go out on their own

When	What the client receives
They buy credits	A receipt with the credits added and the new balance
A booking takes the balance to 2, 1 or 0	A low-balance or out-of-credits notice
Credits are added back, such as a cash payment, refund or promo credit	An email with the credits added and the new balance
A session is three days away and they have 0 or 1 credit	A reminder to top up before the session
They cancel within 48 hours of a session	A late-cancellation notice explaining the forfeited credit

Package clients also get a reminder the day before the final session of their package, which is the natural moment to renew.

A cancellation policy you do not have to enforce by hand

When a client cancels in the portal within 48 hours of the session, one credit is forfeited and the client gets an email that explains why. The rule is applied the same way to every client, which takes the negotiation out of it. Put the policy in your financial responsibility form, which clients e-sign during intake through ESIGN and UETA e-signatures, so it is agreed before the first session.

Packages and superbills together

Prepaid does not have to mean out of pocket for good. Clients with out-of-network benefits can still claim them: a superbill lists each completed session with its CPT code and the amount paid, whether the session was paid by card at booking or drawn from credits. If you are setting prices, the session rate calculator helps you work out a package price that covers your costs.

Who it is for

Prepaid credits suit practices where clients come regularly and pay privately:

• Life coaches who sell coaching packages rather than single sessions.
• Therapists with weekly private-pay clients who want to stop invoicing after each session.
• Marriage and family therapists, where couples and family sessions cost more credits than individual ones.
• Counselors who want a cancellation policy applied the same way every time.

To see credits, packages and the reminder emails set up with your own session prices, request a demo.