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.

• Selecting the correct payer ID
• Searching for additional payers
• Verifying a payer before submitting a claim

Selecting the correct payer ID

A five-digit payer ID is required when adding a client’s insurance information. Payer IDs are unique and are used to submit claims electronically through our clearinghouse.

Note: Insurance payers often use different payer IDs depending on the clearinghouse they’re working with. Because of this, payer IDs are unique in SimplePractice.

To select the correct payer ID, first upload the client’s insurance ID for reference. To do this:

1. Navigate to the client’s Overview page
2. Click Edit > Billing and Insurance
3. Scroll down to their Insurance info
4. Click + Insurance info
5. Under Insurance card, click browse to upload the front of the insurance card

6. Click browse under Back of insurance card to upload the back of the insurance card
7. Click Save

Note: Uploading the front and back of a client’s insurance ID to their file is highly recommended, as many claim errors that lead to scrubs, rejections, or denials are because insurance information wasn't correctly entered. With a card uploaded, you’re able to review the information if you encounter any claim issues.

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

1. Navigate to Settings > Documentation > Intake documents
2. Check the Insurance box next to Demographics form

Once the client’s insurance ID is uploaded, review the front and back to see if there are any special online filing instructions. If there aren’t any special instructions, search the payer’s name using the Insurance payer dropdown under the client’s Insurance info.

After selecting the payer, add the Member ID and any other relevant details, such as Copay/Coinsurance, and click Save.

Searching for additional payers

Searching for a payer in a client’s Insurance info will only show the name and payer ID. You can perform an expanded search by navigating to Settings > Client billing and insurance > Payers and clicking Add payer > Payer search.

This is helpful for payers that have different payer IDs associated with them, or unique claim filing rules. If a payer has multiple unique IDs, look for the one with the closest description to that on the client’s insurance ID or with a matching address.

After locating the correct payer ID, return to the client’s file and add it to their insurance information.

Tip: Click + Add to add a payer to your insurance payers list so you can submit an enrollment. For more information, see Submitting enrollments to file claims and receive Payment Reports.

Verifying a payer before submitting a claim

Selecting the correct payer ID can be difficult, as insurance payers can go by multiple names or have different plans to choose from. 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.