We’re excited to welcome you to SimplePractice from Luminello. SimplePractice offers fully integrated insurance billing, including primary and secondary claim filing, and enrolling to receive electronic Payment Reports (ERAs). As part of your transfer to SimplePractice from Luminello, your clients’ insurance information will transfer. However, your insurance enrollments will need to be resubmitted through SimplePractice. For details on what enrollments mean in SimplePractice, see Enrollment types in SimplePractice.
Here’s what you can expect in the coming months:
- On February 12, 2024, you received an email and a banner in your Luminello account letting you know that Luminello and SimplePractice were teaming up to better serve clinicians like you.
- Starting February 14, 2024, solo Account Owners can opt into the transfer to SimplePractice, while group Account Owners can opt in starting in April.
- As soon as you agree to transfer and gain access to your SimplePractice account, you can begin enrolling with insurance payers through SimplePractice. For more information on what you can do in your account before your data transfers, see Timeline for transferring to SimplePractice.
- You’ll later be notified of your future transfer date via your Luminello account and email.
- For a thorough walkthrough of the timeline for transferring, see Transitioning from Luminello to SimplePractice.
Important: Enrollments can take 2-8 weeks on average to process, with some payers requiring more time. Because of these processing times, we recommend submitting enrollments as soon as you’ve agreed to transfer to SimplePractice and have access to your SimplePractice account.
In this guide, we’ll cover:
Enrollment types in SimplePractice
Enrolling is the process of letting a payer know you’ll be filing claims or receiving Payment Reports through our clearinghouse. There are two enrollment types in SimplePractice, Claim filing enrollments and Payment Report enrollments.
Payment Reports are our version of ERAs (electronic remittance advice). Payment Report enrollments are more common and allow you to receive automated claim updates. Claim filing enrollments are only required by some payers. When required, a claim filing enrollment must be submitted and accepted before you can file claims to that payer.
Once enrolled, Payment Reports are automatically posted to your claims and will notify you if they’ve been Paid, Denied, or applied to a client’s Deductible. For more information, see ERAs in SimplePractice (Payment Reports).
Important: Insurance payers only send Payment Reports to one clearinghouse. Once your enrollment is accepted in SimplePractice, you’ll no longer receive Payment Reports in Luminello. For more information, see our section on Enrollment processing times for specific payers.
Understanding payer IDs in SimplePractice
The first step in submitting an enrollment is to identify the payer IDs of insurance payers you work with. Payer IDs in Luminello may differ from the payer IDs in SimplePractice. In SimplePractice, Payer IDs are five digits and are the primary means of identifying a payer for claim and enrollment submissions. We’ve included a table below containing all of the insurance payers available in Luminello, their Apex IDs, Luminello payer IDs, and corresponding SimplePractice payer IDs.
Here are some things to keep in mind when searching this table for a payer:
- You can quickly search for a specific ID or payer name by clicking Command + F on Mac or Control + F on Windows.
- This table includes Apex payer IDs and their Luminello payer IDs. For the closest match, we recommend starting with the Luminello payer ID.
- Some Luminello payer IDs will be identical to their corresponding SimplePractice payer ID.
- Not supported indicates the payer doesn’t have a connection with our clearinghouse for claim filing or Payment Reports. If you need to file claims to a payer that isn’t available in SimplePractice, you’re able to prepare and download those claims for submission outside of the platform. For steps on how to do this, see Creating and printing a CMS 1500 (HCFA) claim form.
You can search our list of payers and their IDs in the Payers page of your account. To search for a payer ID:
- Navigate to Settings > Client billing and insurance > Payers
- Click Search available payers
- Enter the payer name in the search bar to find its ID
- Click + Add to add the payer to your Payers list
Adding insurance payers to your Payers list allows you to manage enrollments, which we’ll cover in the next section.
If you’re unable to identify a payer ID, submit an email help request to our team and we’ll be happy to help. You can also review our guide on Adding insurance payers and selecting the correct payer ID.
Submitting an enrollment
After you’ve added a payer to your Payers list, you can submit your enrollment.
A Ready to file claims status under the Claim filing enrollment column means an enrollment isn’t required to file claims.
A Ready to enroll option under the Claim filing enrollment column indicates that an enrollment must be submitted and accepted before you can start filing claims.
If a payer has Ready to enroll in each column, as pictured above, it’s highly recommended that you submit both enrollments at the same time so you’ll be set up as quickly as possible to submit claims and receive Payment Reports.
When submitting an enrollment, you’ll want to have the following information:
- The billing NPI that's on file with the payer and approved to file electronic claims
- The Tax ID or Social Security number associated with your billing NPI
- The name (personal or organization) and address associated with your billing NPI
Once you have this information, follow these steps to submit your enrollment:
- Click Manage
- Click Enroll
- Confirm you’ve acknowledged the information on display and click Begin Enrollment
- If you see both enrollment types in Step 1, it’s highly recommended that you select both, as this means the payer requires you enroll to file claims
- Click Continue to Billing Information and enter the required information in each step
- After completing each step, review your information and click Submit Enrollment
Once submitted, you can click Manage next to the payer to view its enrollment status.
We’ll email you once your enrollment is accepted, or if there are any errors that require your attention. Skip to troubleshooting enrollment issues for an overview of scenarios that may require your attention.
Note: For a full walkthrough of the enrollment process, see Submitting enrollments to file claims and receive Payment Reports.
Enrollment processing times
Enrollment processing times vary by payer. On average, enrollments can take between 2-8 weeks to move from submitted to accepted. It’s ultimately up to the payer how long an enrollment takes to process, and because delays can be expected, it's recommended that you submit your enrollments as early as possible.
You can review this guide for a more detailed explanation of enrollment processing times as well as a table that lists expected enrollment processing times per payer: Average payer enrollment approval times.
Important: We recommend searching this table for payers you work with often. If you find that some payers take longer than 8 weeks on average to process enrollments, we recommend submitting those enrollments first.
Troubleshooting enrollment issues
The enrollment process varies by payer. Some payer enrollments only require that you enter your billing information and submit the enrollment from your SimplePractice account, as outlined in the previous section. Others require that you complete additional documentation. If this is a requirement, you’ll receive an email asking you to complete the enrollment, accompanied by an Info required status.
If an enrollment requires additional documentation, click Manage Enrollment and complete the steps on the next screen.
If an enrollment is submitted with billing information that doesn’t match what the payer has on file, or if there is a required document that’s uploaded incorrectly, payers can reject enrollments. If an enrollment is rejected, click Manage and select Manage Enrollment to review the reason, make the necessary changes, and resubmit the enrollment accordingly.
Delays and rejections are the most common issues that can arise when submitting enrollments. An enrollment can be considered delayed if more than 8 weeks have passed, or if the average enrollment processing time for that payer has passed.
If you’re experiencing an enrollment delay or rejection, you can submit an email help request and our insurance team will work with you to get the enrollment accepted.For more information, you can also review our guide on Resolving rejected enrollments.
Manually adding insurance payments
Payment Reports are recommended because they automate your insurance bookkeeping by automatically posting insurance payments. You’re also able to manually add insurance payments. Manually adding insurance payments is recommended if:
- You need to record payments that were received before you began receiving Payment Reports
- You receive insurance payments but you’re not yet set up for Payment Reports
- You submit claims to a payer that doesn’t offer Payment Reports
Important: Your clients and future appointments will be transferred over to your SimplePractice account during your transfer. Do not add existing clients or upcoming appointments to your SimplePractice account. The steps below should only be taken after the data transfer is complete.
Insurance payments can be added from a client’s profile or from your Insurance payments page.
Click Add Insurance Payment to do this from a client’s profile.
You can also navigate to your Insurance payments page and add a payment from there.
This is recommended if you’re adding an insurance payment from one payer that covers several clients.
When adding an insurance payment, the Payment Details section includes:
- The date the payment is received
- The payer
- The payment method
- The payment number
- The amount
When you enter an amount in the Payment Details section, it’ll be accompanied by an unallocated amount. This is the amount you’ll then allocate to the appointments being covered by the payment.
When allocating the payment to the date(s) of service, enter:
- The client owes amount (copay or coinsurance)
- Insurance paid amount for that date of service
- The insurance write-off
After you’re done, click Save Payment. For a full walkthrough of this process, see Adding insurance payments.
- What will happen to my enrollments in Luminello?
- Do I need to contact SimplePractice’s clearinghouse?
- Do I need to cancel my Apex account?
What will happen to my enrollments in Luminello?
Insurance payers only send Payment Reports to a single clearinghouse. This means that once a Payment Report enrollment is accepted in SimplePractice, you’ll no longer receive ERAs for that payer in Luminello.
To keep your records accurate, you can manually add an external insurance payment in your Luminello account if you’ve received payment and received your Payment Report in SimplePractice.
If you’ve received payment, but need additional information that’s typically included in an ERA, you can reach out to the payer and request they send an official EOB. Some payers will also let you view this information on their online portal.
If you submit a claim through Luminello, and your Payment Report enrollment has been accepted in SimplePractice, you’ll only receive a Payment Report in your SimplePractice account. Payment Reports that are received for claims submitted outside of SimplePractice won’t display the client’s name and can’t attach to a claim.
Important: Your Payment Report will not be available in your Luminello account.
After your data has been transferred, you can attach an insurance payment to a claim by:
- Reaching out to the payer and requesting the EOB
Adding the date(s) of service from the payment to your calendar
- This allows you to create a placeholder claim
Creating the claim
- This will serve as a placeholder that doesn’t need to be submitted since you already submitted the claim outside of SimplePractice. You can leave the claim in the Prepared status, and after the payment is attached it’ll update to Paid
- Locating the payment in your Insurance payments page and allocating it to the date(s) of service
If you need help with this, please reach out to our team and we’ll be happy to guide you through the process.
Do I need to contact SimplePractice’s clearinghouse?
Our Customer Success team works directly with our clearinghouse. If you have questions about an enrollment, please reach out to our team and we’ll work with our clearinghouse directly.
If you need assistance while filing claims, you can also contact our team and we’d be happy to assist.
Do I need to cancel my Apex account?
Once your enrollments are accepted and your data is transferred, you can manage your insurance billing through your SimplePractice account. Once your enrollments are all accepted in SimplePractice, you can cancel your Apex account. For steps on how to do this, see How do I cancel my ApexEDI account?