Enrollment FAQ

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FAQ ABOUT CLAIM FILING ENROLLMENT

1. What is Enrollment?

2. How can I find out if my insurance providers require enrollment for claims and/or payment reports?

3. What if I was already enrolled with my payer prior to SimplePractice?

4. What are the requirements to enroll for claim filing or payment reports?

5. How long until my enrollments are accepted by the insurance provider?

 

1. What is Enrollment?

Enrollment is simply the process of informing your client's insurance company that you plan to submit electronic claims via SimplePractice and/or that you wish to receive electronic EOB's, also called payment reports through SimplePractice.  

When you start managing your insurance through SimplePractice, you will need to notify some payers that you plan to use our software.  You can manage the process of any required enrollments directly through SimplePractice in almost all cases, with just a few clicks of the mouse.  

Note:  Enrollment is NOT the same as getting 'paneled' or 'credentialed' with an insurance payer.  If you are enrolling with a payer through SimplePractice, you will likely need to already be paneled with an insurance payer in order for them to approve your enrollment.  SimplePractice does not assist with credentialing.    

 

 

2. How can I find out if my insurance payers require enrollment for claims and/or payment reports?

Many payers do not require that you enroll for claim filing.  
Some payers DO require that you enroll for payment reports. 
 
If enrollment for either claim filing or for payment reports is required, you must be on a paid account with SimplePractice and have at least 1 client that is listed as using that insurance. 
 
Here's how to check and see if your client's insurance companies require enrollment: 
  • Go to My account > Settings > Insurance Providers
  • Start typing the name of your payer into the text box
  • When you have located your payer, check the "Claim filing" and "Payment Reports" column to see if claim filing is available or required
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What do the column statuses mean?  
 
Not Required: Enrollment is not required for this payer.  Go ahead and start submitting claims right away!  
Paid Account Required: This means that enrollment IS required, but you are not yet on a paid account with SimplePractice.  Upgrade in order to enroll
No Clients on File: You are on a paid account, but have not yet entered this payer into any of your client profiles.  Enrollment requires a paid account and at least one client using the payer in order to enroll.
PR's Not Supported: Payment reports are not available for this payer.  You will receive paper EOB's.
+Enroll: Click on the +enroll button in order to complete the simple application form to your payer.  We handle the rest!

3. What if I was already enrolled with my payer prior to SimplePractice?

 

Even if you've enrolled directly with an insurance company or through another clearinghouse, you still need to enroll through SimplePractice in order to set up the connection.  Previously submitting claims electronically with a payer does not correlate to a faster acceptance through SimplePractice, unfortunately. 

4. What are the requirements to enroll for claim filing or payment reports?

If enrollment is required for a payer, you must:
  • Have a paid account with SimplePractice
  • Have at least one client on file with that payer entered into their profile (Client > Edit Client info > Billing & Insurance Tab)  

5.  How long until my enrollments are accepted by the insurance payer?

Every payer takes a different amount of time to approve their required enrollment forms. Some are approved in 1 business day, while others (i.e., Medicare and Medicaid) can take upwards of 2 months. However, most payers take less than 30 days. 
 
We recommend that until your enrollments are approved, you submit claims by mail to avoid any delays in reimbursement for your sessions. 
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