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Payer Claim # vs. Clearinghouse Reference #

Payer Claim # vs. Clearinghouse Reference #

All claims submitted through SimplePractice will get assigned a unique Clearinghouse Reference #, which our team uses for locating a claim. Later, once the payer receives and processes a claim, it may then also be assigned a unique Payer Claim #, which would be used for tracking a claim in the payer's system. It's important to understand the difference between these two identifiers so that you can correctly reference a claim.

Clearinghouse Reference #

The Clearinghouse Reference # is the identifying number that our clearinghouse assigns to each claim. You can use this ID # if you need to reach out to our support team for help with a specific claim.

Important: If you need to contact the payer, please don’t use the Clearinghouse Reference # to reference the claim, as this number is only used by our clearinghouse internally. 

If a claim is displaying a scrub error, this means it hasn't been successfully submitted to our clearinghouse yet. Claims in this status will not be assigned a Clearinghouse Reference # until they reach the clearinghouse.

Payer Claim #

The Payer Claim # is the unique reference number assigned to a claim by the insurance payer. If you need to contact the payer directly about a claim, you’ll want to reference the claim using this number, or by providing the client's member ID number and the dates of service included on the claim in question.

A payer will assign this number to a claim once they've accepted the claim into their adjudication system - which is where they process the claim and decide whether or not the claim is eligible for reimbursement. 

You may notice that some payers never share a Payer Claim #. That doesn't mean that the claims aren't reaching their system, it just means that the payer doesn't support that service through our clearinghouse.

If a claim is rejected by the payer's automated system, it likely will not list a Payer Claim #, as it would have been rejected before entering the adjudication process. 

Tip: For information about re-submitting a claim with corrections, please see this guide: When to submit a corrected claim in SimplePractice and how.

Locating the reference numbers assigned to a claim

If a claim has been assigned a Payer Claim # and a Clearinghouse Reference #, these numbers will be listed directly under the client's name:
claim.simplepractice.referencenumbers.png

If there have been multiple submissions of the same claim, you can click Claim Details next to the client's name to find the claim filing history including any previous reference numbers.

Important: Before deleting any claims from your SimplePractice account, we always recommend recording any associated reference numbers as this information will not be stored when a claim is deleted.

 

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