Any pro bono or unpaid work is not considered deductible by the IRS. If you never collect a fee, either because the patient didn't pay or didn't show up, there was no revenue; therefore, you cannot deduct this as an expense.
Heard uses the Cash Method of accounting, which means we only account for income that is actually received, not income that was written off and never received. As a result, there is nothing to expense, and you're only taxed on what's received. Unfortunately, you cannot write off the difference in the fee.
Should I track sliding scale clients?
You can track sliding-scale clients if you'd like, but Heard accounts for your income and expenses on a cash basis. This means we only record what's received or spent, so your Heard account won't reflect any deductions for income not received. Unfortunately, you cannot write off the difference in the fee.