Staying on top of insurance billing processes is a full-time job that requires continuous education and certifications. Many practices handle insurance billing on their own early in their practice’s lifecycle. 

As your practice grows, it’s important to spend more time on client care, and less time on managing insurance billing. That’s why SimplePractice offers a managed billing service for in-network insurance billing.

• Learning more about managed billing
• Setting up your account for managed billing
• Locking and signing progress notes
• Reviewing clients’ insurance benefits
• Using claim support to communicate with managed billing
• FAQs

Learning more about managed billing

Managed billing is a best-in-class insurance billing solution that’s fully integrated with SimplePractice. Managed billing takes care of your in-network insurance billing to not only give you time back, but also to make sure that you get insurance claims paid faster and more successfully. Additionally, you won't have to deal with rejections, denials, or appeals - we’ll handle all of those completely on your behalf. 

Our managed billing team consists of billing specialists, revenue cycle experts, and engineers dedicated to making insurance billing easier for customers.

If you’re eligible for this service, you’ll receive an email from SimplePractice with information on how to start the process of working with our managed billing team.

Note: Practices must be on the Plus plan to be eligible for this service. If you’d like to learn more about managed billing, click here to schedule a 15-minute exploratory call. 

Setting up your account for managed billing

Because managed billing only handles in-network insurance claims, you’ll now have the option to mark insurance clients as in-network or out-of-network. 

While onboarding with managed billing, all insurance clients will be pre-selected as In-network insurance for their billing type. Before your go-live date, you’ll want to go through your client list and make sure any Out-of-network clients are properly denoted. 

Tip: Filtering your Clients list by insurance payer can help when searching for any out-of-network clients.

When creating new clients, you’ll be able to select their correct billing type. 

Locking and signing progress notes

After reaching your go-live date, our team will manage the full process of creating, submitting, and managing claims. Managed billing will only submit claims if a session’s progress note is locked and signed.

After you’ve locked and signed a session’s progress note, a claim will be created and the managed billing team will manage the claim throughout the adjudication process, as well as handle any rejections, denials, or resubmissions.

Note: Once the claim is created, you won’t be able to make any edits to it.

If a clinician in your practice is under supervision, we’ll only create a claim once the progress note has been locked and signed by the supervisee and the supervisor. For more information, see Adding a Supervisor to review and sign notes.

You can use the notes filter in the Unbilled appointments page to sort appointments based on their notes status, including any that are unlocked or don’t yet have a note. 

Additionally, managed billing will only manage claims for appointments where the date of service took place after your go-live date. You’ll still be able to create, submit, and manage claims for dates of service that took place prior to your go-live date.

Reviewing clients’ insurance benefits

Once you’ve onboarded with managed billing, automatic insurance checks will run for clients with recently updated insurance information, and for any upcoming insurance appointments. This allows you to confirm that a client’s coverage is active before a claim is submitted. If our clearinghouse finds that a client’s listed coverage is inactive or needs review, you can make changes before the appointment takes place and reduce the likelihood of future rejections or denials. 

To address a client’s coverage:

• Navigate to your Insurance page
• Select the Review client coverage tab

Note: This tab will only list clients whose coverage is inactive or needs review.

• View the Details column for information regarding the client’s coverage
• Click Review to be taken to their insurance information

• Update the client’s insurance information as needed

After updating the client’s insurance information, a new coverage report will automatically be requested. If our clearinghouse is able to verify the client’s updated insurance information, it’ll be listed as Active in their profile. 

Using claim support to communicate with managed billing

Once onboarded with managed billing, you can use claim support to send and receive secure messages regarding specific claims. Claim support can be used to contact managed billing for any claim that was created after your go-live date. Managed billing may also reach out to you directly through claim support if action is needed on your part to process a claim. 

To view new messages from managed billing: 

• Navigate to Insurance > Claims
• Click View Details to go directly to the claim in question

• You can also set the Claim support filter to only show claims with New messages

• Click the message icon to open the claim support thread

To start a new claim support thread: 

• Navigate to Insurance > Claims
• Click View next to the claim in question

• Click Contact claim support on the top right corner 

• Choose a Category from the dropdown

• • Categories you can contact claim support for include: 
    • Payer ID issues
    • Inactive coverage
    • Incorrect NPI 
    • Incorrect client information
    • Missing information
    • Missing payment
• Enter your message and click Save to send it to our team

• Our team will investigate and follow up shortly 

Claim support shouldn’t be used for non-claim issues. If you need to reach out to managed billing for a non-claim issue, please submit an email help request.  

FAQs

• What type of insurance filing does managed billing support?
• What's included with managed billing?
• What isn’t included with managed billing?

What type of insurance filing does managed billing support?

Managed billing only supports the management of in-network insurance claim filing. For out-of-network insurance claims, clinicians will need to continue to submit these independently.

What's included with managed billing?

Managed billing is a fully integrated service that includes: 

• Automatic insurance status checks
• Claim scrubbing and custom claim edits
• Electronic primary and secondary claim submission for government and in-network commercial payers
• Claim status management
• Rejection and denial management
• Accounts receivable (A/R) follow-up with insurance payers
• Insurance payment posting 
• Transparent and actionable reports
• Dashboard to track important tasks and insurance billing metrics 
• Real time claims tracking

What isn’t included with managed billing?

Services that aren’t offered with managed billing include:

• Credentialing
• Payer negotiations
• Accounts receivable (A/R) follow-ups for claims filed before your start of service date
• Prior authorizations
• Billing, invoicing, or A/R follow-up with clients
• Out of network and EAP billing