Submitting enrollments to file claims and receive Payment Reports

Enrolling with insurance payers through SimplePractices allows you to submit claims electronically and receive Payment Reports (ERAs). While most payers don’t require you enroll to file claims electronically, an enrollment is always required to receive Payment Reports. 

In this guide, we’ll cover:

• Submitting an enrollment
• Tracking your enrollment status
• Enrollment tips and reminders

Note: Enrolling isn’t the same as credentialing. You’ll need to already be credentialed with an insurance payer for them to approve your enrollment.

Submitting an enrollment

Enrollments can be submitted to several payers at once, and multiple enrollments can be submitted to a payer if you’re part of a group practice. To submit an enrollment: 

1. Navigate to Settings > Client billing and insurance > Payers
2. Click Add enrollments

3. Check the payers from your list you’d like to enroll with

4. If you’re not seeing a payer you’d like to enroll with, click Add new payer to include them in the list

5. Click Continue

Next, you’ll choose which enrollments you’d like to submit to your payer(s), along with your billing information.

For each payer: 

1. Check the box for each type of enrollment you’d like to submit
   • If Not required by payer appears under Claim filing, you won’t need to submit an enrollment to file claims electronically to the payer through SimplePractice

2. Select whether you’ll submit your enrollment(s) with your Individual (Type 1) NPI or Organization (Type 2) NPI
   • This should be the billing NPI that’s on file with the payer
   • If you’re billing as an organization, this would typically be your group NPI

3. Enter the information you have on file with the insurance payer, including:
   • The billing NPI that’s on file with the payer 
     • If you’re billing as an organization, this will typically be your group NPI
   • The Tax ID or Social Security Number associated with your billing NPI
     • For group practices, this may be a unique number tied to your group NPI
   • The full name (personal or organization) and address associated with your billing NPI
4. Click Continue

5. Review the information you've entered and click Submit 

Note: If submitting enrollments to multiple payers at once, the same set of billing information will be submitted to each. If you have unique sets of billing information for different payers, we recommend submitting those enrollments individually.

Tracking your enrollment status

Enrollments go through clearinghouses and can take several weeks to process. Additionally, some payers require that you complete documentation before accepting the enrollment. As you submit enrollments, you can monitor their progress from your Payers page using the status filters.

Enrollments with the Submitted or Pending status can be left to process, and we’ll email you once they’re accepted. 

The Action Required status indicates that an enrollment needs to be resubmitted, or requires additional documentation before it can be accepted. Click View Details to go to the enrollment’s details for next steps. 

After clicking View details, an Info required status under an enrollment column indicates that the payer requires additional documentation. Click the Manage dropdown and select the enrollment to complete the additional steps. 

Enrollment tips and reminders

As enrollments can save time by automating your bookkeeping, we recommend submitting them as soon as you begin using SimplePractice for insurance billing. We recommend the following to make sure your enrollments can process efficiently.

Confirming billing information

Rejections are commonly caused by submitting billing information that doesn’t match what the payer has on file for you. We recommend double-checking your billing information before submitting enrollments. If you’re unsure which information to use, reach out to the payer for confirmation. For more information, see Resolving rejected enrollments.

Choosing the correct NPI

Only one enrollment can be submitted per NPI to a single payer, which means that you can’t enroll with a payer with the same NPI through multiple accounts. If you use multiple SimplePractice accounts and would like to enroll with a payer through a different account, submit a help request through this different account with the following information:

• The payer name and payer ID for the enrollment  
• The NPI number submitted on the enrollment 

Once our team has received this, we can help you transfer your enrollment.

Manually adding insurance payments

Insurance payments only post automatically once your Payment Report enrollment is accepted. While waiting for your enrollments to process, we recommend manually adding insurance payments to keep your bookkeeping up-to-date. For more information, see Adding insurance payments.