How do I bill clients who haven't met their Deductible?

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We have two ways for you to manage deductibles depending on the way that you work with your clients.

 

In Network Providers

Option 1: You client will only pay you the contracted or allowable amount the insurance should have paid you (This is the most common way we see our customers working with deductibles). 

Here's an example:

Your rate is $150 → Deductible not met → Client pays you only the contracted/allowable rate of $95 and you write off $55. In this scenario, you will need to enter an insurance payment in order for you to record the $55 write-off. The insurance payment will be for $0. 

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If you will write off a portion of the client's session fee when the deductible isn't met, there are the steps you need!Go to the client's billing details page. 

Click Add Insurance Payment (the usual way to add an insurance payment). 

Update the amount that you wish to charge the client in the Co-pay field. Don't worry if your client already paid you this copay amount. SimplePractice will only charge them the difference. 

Now click the "reload" arrows to complete the write-off amount.(**Very important step**)

Do the same for any other session where the $0 payment applies. 

Click Save

Click Client's Name to return to the client's profile. 

Click Billing

Now that you've told SimplePractice that insurance is paying $0, we need to create the invoice to bill the client for the difference that they owe. Click Uninvoiced.

Click OK

Make any edits to the invoice (i.e. add a description that highlights the reason for this new invoice.)

Click Save

You can now add a payment or click "x" to Close

You'll see the $0 insurance payment and the updated client balance. That's it. You're done.

Note: After you save your $0 payment, you'll see the following message at the top of your screen. The message is just a reminder to let you know that you've entered a $0 in case this was done by accident. Since you intended to add a $0 payment, you can ignore the message.  

 

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When you return to your client's billing page, you'll see that your $0 payment was applied to your sessions. You want to see the $0 insurance payment in green writing and want to make sure that the Write-Off is showing in the break down of this session. You can now create an invoice for your client for the $95 they're responsible for paying.

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Out of Network Providers

Option 2: Since you're an out of network provider, you're not bound by a contracted or allowable amount by the payer and your clients pay you your full session fee when the deductible isn’t met. 

Example: Your rate is $150 → Deductible not met → Client pays you $150.

In this case, you will need to change the Billing Type for each individual session from "Insurance" to "Self-Pay". Once you do this, the system will understand that now the full session fee is the client's responsibility.

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How do deductibles work if I'm receiving Payment Reports?

If you receive online Payment Reports from the payers, SimplePractice will send you a report with the claim marked "Deductible."

If you receive a payment report for a claim that was applied to the client's Deductible, SimplePractice won't automatically record the $0 payment. You do still need to create a manual insurance payment using the Payment Report info so that you can enter the correct write-off amount.  

 

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