Submitting an enrollment to receive payment reports and/or file claims through SimplePractice is a crucial step to starting the insurance billing process. During this process, you may encounter an error or a rejection of your enrollment.
In this guide, we'll cover:
- What causes an enrollment to be rejected?
- Resubmitting your enrollment
- NPI and Tax ID is not in the insurer's file
- Status 400 NPI XXXXXXXXXX has already been taken for this payer
- Provider is linked to another clearinghouse
What causes an enrollment to be rejected?
If your enrollment is rejected, you can refer to this guide for insight on how to resolve the error and resubmit your enrollment. Some common reasons an enrollment may be rejected include:
- If the Billing provider information doesn’t match what the insurance payer has on file
- If an enrollment for this payer has already been submitted through SimplePractice
- If the provider is linked to another clearinghouse
Resubmitting your enrollment
If your enrollment is rejected, you can resubmit it. To do this:
- Navigate to Settings > Insurance
- Click the rejected icon
- Choose Resubmit Enrollment to continue
- Click Yes, I want to resubmit
- Select the enrollment types(s) you’d like to resubmit
- Click Continue to Billing Information
- Update any incorrect enrollment fields
- After updating your Billing Information, click Continue to Signature
- Enter your signature and click Continue to Review & Submit
- Review all of the information and click Submit Enrollment
You'll now see that the enrollment status has been updated to Submitted, which means now you’ll need to wait for the insurance company to review and process your enrollment. If your enrollment requires additional steps, see: Why is my enrollment requiring additional steps?
NPI and Tax ID is not in the insurer's file
This error message is due to the enrollment being submitted with a NPI, Tax ID, or address that's not on file with the insurance payer. It's important to contact the payer directly to confirm that they have your up-to-date information before you resubmit an enrollment application. Here’s the information you’ll want to confirm when contacting the payer:
- The billing NPI that’s on file with the payer and that’s approved to file electronic claims
- If you’re billing as an organization, this will 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
After confirming the information the payer has on file, see Resubmitting your enrollment.
Status 400 NPI XXXXXXXXXX has already been taken for this payer
This rejection message appears when you've submitted an enrollment with this payer previously via a different SimplePractice account. This can happen if a clinician starts their own solo account after being part of a group practice SimplePractice account, and vice versa. We can help you to fix this.
Please submit a help request with the following information, and we can assist from our end:
- The payer you’re receiving this error message with when trying to enroll
- Please provide the payer name and payer ID
- The NPI number you’re receiving this error message with
Provider is linked to another clearinghouse
This error occurs when you submit an enrollment to receive electronic payment reports, but you’re already receiving payment reports through another clearinghouse. Payers only send payment reports to a single clearinghouse, and when you encounter this rejection, you’ll need to inform our clearinghouse that you’d like to receive payment reports through SimplePractice going forward. In order to resolve this rejection error, you'll need to submit a Change of Vendor letter.
The Change of Vendor letter must include the following information:
- Your name, address, and today's date at the top. Then, include a short paragraph stating the following:
- "Please update my enrollment with [INSURANCE PAYER] to receive Payment Reports through SimplePractice. Below is the requested information:
- TIN (tax ID number):
- NPI:
- Payer Name:
- Payer ID: [This can be found in your My Insurance Payers page]
- Clearinghouse / Company Name / User Id: Eligible, inc. GATE0164"
- "Please update my enrollment with [INSURANCE PAYER] to receive Payment Reports through SimplePractice. Below is the requested information:
Lastly, please sign the bottom of the letter and print your name. When you’ve completed the letter, please submit a help request. Once we receive that, we'll submit it to our clearinghouse to continue processing your enrollment.
Note: Please only provide a Change of Vendor letter if your enrollment rejection message specifically asks you to submit one, as not all payers require this.