With SimplePractice, you can auto-generate multiple claims at the same time.
In this article:
- How to create batch claims
- When a batch claim is not created
- How do I remove appointments from the Unbilled Appointments list
Note: The Unbilled Sessions tab will list all clients whose billing type for an appointment is set to Insurance pay and is not included on a claim.
How to create batch claims
- From the Calendar homepage, go to Billing > Insurance.
- On the Unbilled Appointments page, you’ll see a list of all billable insurance appointments that have not been included on a CMS 1500 (HCFA) form. You can read more about how to check for unbilled appointments here: Appointment Status Report: Finding unpaid sessions.
- Under the Appointments column, you will find the number of unbilled insurance appointments a client has.
- Click on the + symbol to view the appointment date, CPT code, and billed amount. This is also where you can determine which appointments you would like to include on batch claims.
Note: You can include up to six appointments on a claim.
Note: If your account is missing the Tax ID or an address, you cannot create claims from this page until these fields are complete.
Now, you will see all of the unbilled appointments with the Insurance billing type for the selected client, and can choose which appointments are included on the batch claim by using the box to the left of the appointment details. unchecking the box means that the appointment will not be included on the batch claim.
Note: Appointments with the Self-Pay billing type are not included on this page. If you need to create claims for Self-Pay appointments, you can generate them from the client's Billing page. See Creating and printing a CMS 1500 (HCFA) claim form to learn how.
- Click Create Claims or Create & Submit Claims to create a batch of claims for all the client's listed on this page.
- Clicking on the Create Claims button will create claims for all appointments on this page, but will not submit the claims. When a claim is created, the appointment(s) will be removed from the Unbilled Appointments list. All created claims will be found under the Claims tab on the Insurance page and the Client’s Billing page.
Clicking the Create & Submit Claims button will create and submit claims to the insurance payer for all appointments under the Unbilled Appointments tab.
- From the Claims tab, you will see the newly created claims listed at the top of your claims list, as shown below.
- Review, edit, and file these batch claims just as you would any other claim. You can read more about filing claims here: How to file a claim.
FYI: If one of your client's has more than 6 unbilled appointments (the maximum amount allowed on a CMS claim form), SimplePractice will generate multiple CMS claim forms to accommodate all of the billable appointments.
When a batch claim is not created
Sometimes claims won't be generated for an individual client when you click the Create Claims button. When this happens, it means that SimplePractice does not have all the required client information to auto-populate a claim form for that client. If you see an orange exclamation point next to the client’s name, this indicates that there’s missing information that the insurance payer requires on a CMS 1500 (HCFA) form.
To see what information is missing and to be taken to the Client Info page to add the required information, follow these steps:
1. Click on the orange exclamation point next to the client's name to see what information is missing.
2. Clicking Add Missing Info will take you to the Client Info page to update this information for the client.
Note: You can read more about the minimum fields required to create a claim and about missing information when batch billing in these guides: What information do I need from the client to file a claim? and Missing information when batch billing.
How do I remove appointments from the Unbilled Appointments list
If you’ve filed claims outside of SimplePractice, these appointments will still appear on the Unbilled Appointments list because they are set to Insurance pay. You can remove the appointments from this list by creating a claim. You don’t need to submit the created claim since you already have.
To remove insurance pay appointments from the Unbilled Appointments list:
- Go to the client’s Billing page.
- Use the date range window to isolate the appointments you'd like to remove from the Unbilled Appointments list.
- Click +Create, select Claim/CMS1500. You do not need to submit the claim here because you’ve already submitted the claim to the payer outside of SimplePractice.
Now that the appointments have been included on a claim, you should no longer see these on the Unbilled Appointments list. This is because the software now recognizes that these appointments have been put on a CMS claim form for billing.