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Updating coinsurance when adding an insurance payment


If your client is responsible for paying a coinsurance (as opposed to a copay) that can be managed through SimplePractice as well.

On the Billing & Insurance tab enter the estimated coinsurance amount in the Copay/Coinsurance field. This amount will be charged to the client until you revise it later.

Once the claim has been processed, the insurance company will send you an EOB or electronic payment report along with the reimbursement check. This EOB or electronic payment report will include what the client's coinsurance responsibility is for each session.

You will enter the coinsurance information when adding the insurance payment in SimplePractice. If you're not familiar with adding an insurance payment, please review this article: Adding a payment from an Insurance Company.

When adding the insurance payment, update the Client owes field to reflect the client's coinsurance responsibility.


Editing a payment in SimplePractice


When you update the Client owes field and allocate the insurance reimbursement, this will update the client's balance as well as the insurance company's balance. When you return to the client's Billing Details page, you will see the updated coinsurance amount indicated on the session and the client's overall balance due will update.


Updated coinsurance amount in SimplePractice


Note: Insurance payments and coinsurance amounts will be automatically recorded if you're enrolled to receive payment reports from the payer. Learn more about payment report enrollment here: Enrollment for Payment Reports. 

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