For many payers, you can start submitting electronic claims through SimplePractice quickly. However, some payers will require that you submit an enrollment and wait for them to accept it before you're able to start submitting claims.
Here is a summary of the steps of the enrollment process:
- Determine if your insurance payers require enrollment
- Enter payer information into your client's profile
- Complete required enrollments
Step 1: Determine which payers require enrollment
You can quickly and easily locate the insurance payers you work with and assess if they will require you to enroll to submit claims electronically.
Note: Payment reports, if available from a payer, will always require enrollment.
- Go to My Account > Settings > Insurance Payers.
- In the text field, begin typing your payer's name to locate your payer.
- Keep in mind that many insurance payers may be listed under a single payer, so don't worry if there is a large grouping of names with your payer.
Note: The Insurance Payers list only shows the first 50 payers on the list. You most likely will need to use the search option to find the correct payer.
Check the Claim Filing Enrollment and Payment Report Enrollment columns to determine if enrollment will be required.
Here are the designations you may see:
- 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 initiate the enrollment process.
- 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!
Step 2: Enter payer information into your client's profile
Now that you have assessed your payers' enrollment requirements, you can enter your client insurance information into their profiles if you haven't already done so.
- Go to Client Profile > View/edit client info > Billing & Insurance tab. Enter your payers either by payer ID (from step 1) or by typing in the keywords for the payer.
Step 3. Complete required enrollments
Now that you are have entered client information, you need to go back to your settings and enroll for the payers that require enrollment.
- Go to My Account > Settings > Insurance Payers > Enrollments tab. Any payers that you have entered into clients' profiles will now appear in this list. Check the statuses in the Claim Filing Enrollment and Payment Report Enrollment columns to see which payers you can enroll with.
- Click the +Enroll link where available.
- Fill out the required fields.
- Create an electronic signature by holding down your mouse button and creating your signature or by writing with your finger on a tablet.
- When finished, click Submit/Update Payer Enrollment. This will submit your request to enroll claim filing, payment reports, or both.
You'll see this confirmation message:
Once your enrollment request is submitted
You can view all your enrollments and enrollment request statuses on the Enrollments tab.
Typically, it takes between 1-8 weeks for insurance payers to process your enrollment request. Medicare, Medicaid, and some other payers can take up to 8+ weeks.
Note: We've created a searchable table for the average enrollment approval times for the most common enrollments we see, and you can reference it here: Average payer enrollment approval times.
We will email you when your enrollment has been completed or if there are any other steps needed from you in order to complete this process.
Important: If you receive a notice from the payer stating that they've accepted your enrollment, please share it with our team, this will help speed up the process. Sometimes the payers will update the clinicians but not the clearinghouse.
You'll also see the status change from Submitted to Accepted in the Enrollment section of the practice settings. When this happens, you're ready to file claims through SimplePractice!
Note: The PTAN field, as shown below, is only required for Medicare enrollment.
Tip: Interested in never having to worry about insurance again? Learn more about our in-house medical billing service, SmartBilling Pro here.
For additional information on insurance enrollments, check out the following articles: