Adding insurance payers and selecting the correct payer ID

When submitting claims electronically, the most important piece of information is the payer ID. Adding the correct payer ID to your clients’ insurance information reduces the likelihood of encountering rejections or denials.

• Adding payers to your list
• Verifying a payer before submitting a claim
• Removing a payer from your list

Adding payers to your list

Insurance payers often use different IDs depending on the clearinghouse they’re working with. They can also go by different names and plan types, making it difficult to select which to use for electronic claim filing. 

Adding a payer to your Payers list shows all of its possible plan names and IDs in one, consolidated table.

Once a payer is added to your list, it can be searched in other parts of your account using any of the listed plan names or IDs. For example, when adding a client’s insurance information, you’ll see the primary name the payer goes by in your Payers list, its associated plan names and IDs, and an Added badge.

SimplePractice uses a variety of clearinghouses to facilitate electronic claim submissions, and some payer IDs offer a more direct connection. So long as the correct payer is added to your list, we’ll route claims using one of the available IDs. For more information, see Understanding insurance plans and payer IDs.

To add a payer to your list: 

1. Navigate to Settings > Client billing and insurance > Payers 
2. Click Add payer > Payer search

3. Search the payer by name or ID and click + Add next to the one that matches your search 

To add a payer from your list to a client’s profile:

1. Navigate to the client’s Overview page
2. Click Edit client > Billing and Insurance
3. Scroll down to their Insurance info
4. Click + Insurance info
5. Search the payer using the Insurance payer field and click on the one with an Added badge

6. Click Save

We also recommend adjusting your Demographics form so it includes a field for clients to enter their insurance information. To do this:

1. Navigate to Settings > Documentation > Intake documents
2. Scroll down to Demographics and Credit Card Forms
3. Click the three dots next to Demographics form 

4. Click Edit and check the Insurance box

5. Click Save

Under Insurance information, you can also choose to include a request form separate from the demographics form. 

Verifying a payer before submitting a claim

If you’re unsure which payer to pick, we can work with our clearinghouse to verify this for you. In order for us to do this, submit an email help request and include the client's secure URL.

Important: Our team can only verify which payer ID to use if the client has an insurance card uploaded to their file.

Removing a payer from your list

Payers you no longer submit claims to or were added in error can be removed from your Payers list. To do this:

1. Navigate to Settings > Client billing and insurance > Payers 
2. Click View details next to the payer in question

3. Scroll down and click Remove payer on the bottom right

If you’re unable to click Remove payer, it's because the payer is currently assigned to at least one client’s insurance information. 

You’ll need to remove the payer from all clients it's currently assigned to before you'll be able to delete the payer from your list. 

To identify which clients have the payer in their information and unassign it: 

1. Navigate to the Clients page 
2. Search by Insurance payer to see all clients who have that payer assigned to their insurance information

3. Go to the profile of each listed client 
4. Click Edit client info > Billing and insurance 
5. Scroll down to their insurance information 
6. Click the trash icon to delete the payer from their profile, or Edit to assign them a different payer