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Creating batch claims

Creating batch claims

Creating batch claims is an efficient way to get your billing done. Batch claims allow you to include up to six appointments for a single client on one claim. Batch claim filing is highly recommended to save you time and money. 

In this guide, we’ll cover:

Note: The Unbilled appointments tab lists all appointments for clients whose billing type is set to Insurance and aren’t yet included on a claim. Appointments set to Self-Pay aren’t included. 


Creating batch claims

A batch claim is any claim that includes more than one appointment, with six appointments being the maximum amount that can be included.

Note: You can include up to six service codes on a single claim. If more than six are selected for a client, multiple claims will be generated. For more information, see Billing insurance with multiple service codes.

To create a batch claim:

  • Navigate to Insurance > Unbilled appointments
  • You’ll see a list of all billable insurance appointments that haven't been included on a CMS1500 (HCFA) form within the selected date range
    • The date range in the Unbilled appointments list defaults to the last 30 days, so try expanding the date range if the appointment you're looking for isn't listed

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Important: Scroll down until you see There are no more unbilled appointments at the bottom of the Unbilled appointments page to load all applicable dates of service. You’ll want to load all appointments before creating a batch claim to make sure no appointments are unintentionally excluded from the claim.

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  • Click the arrow to view all appointments for a client within the selected date range

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  • Expanding a client’s appointments will reveal appointment dates, CPT codes, modifiers, Place of Service codes, and billed amounts
  • You can filter your search using the insurance payer, clinician, or note status filters to further specify which appointment(s) you’re looking for
    • The note status filter searches for appointments with Locked notes, No notes, Unlocked notes, or notes requiring Supervision
      • Filtering by Supervision shows appointments with a note that’s signed by a clinician under supervision, but not yet signed by their supervisor
      • Once a note is signed by a supervisor, it will fall under the Locked notes filter

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  • If there are multiple appointments for a client, use the check boxes to select which ones to include on the batch claim
    • Unchecking a box means that the appointment won’t be included on the batch claim

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  • Click Create > Create claims to create a batch of claims for all the clients selected on this page

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Important: Clicking Create claims will create, but won’t automatically submit claims.

  • Click Create > Create and submit claims to submit the claims directly from the Unbilled appointments list

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  • Click Create and submit claims

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When a claim is created but not submitted, the appointment(s) are removed from the Unbilled appointments list. All unsubmitted claims can be found under the Claims tab and will be in the Prepared status. You can review, edit, and file these batch claims just as you would any other claim. To learn more about filing claims, see Filing primary claims in SimplePractice.

Note: If one client has more than six unbilled appointments (the maximum amount allowed on a CMS 1500 claim form), multiple CMS claim forms will be generated to accommodate all of the billable appointments. If a client has unbilled appointments from different calendar years, multiple CMS claim forms will be generated for each year since insurance payers will only process claims with dates of service from the same year.


Missing information when a batch claim isn't created

If a claim isn’t generated for an individual client when you click Create claims, it means that they’re missing required information in their file. You’ll see what information is missing by hovering over the orange exclamation point next to a client’s name.

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Clicking Add Missing Info will take you to the client's Client Info tab so you can enter the required information.

Note: To learn about the minimum field requirements to create a claim, see Entering the minimum information required for claims.


Removing appointments from the Unbilled appointments list

If you’ve filed claims outside of SimplePractice, the appointments will still appear on the Unbilled appointments list because they're set to Insurance as their billing type. You can remove the appointments from this list by creating a claim.

Important: You don’t need to submit the claim in this case because you’ve already submitted the claim to the payer outside of SimplePractice.

To remove insurance appointments from the Unbilled appointments list:

  • Navigate to the client’s Billing page
  • Select the date range to isolate the appointments you'd like to remove from the Unbilled appointments list, and click Apply

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  • Click New > Claim/CMS1500

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  • Open the claim
  • Click the download icon to update the status of the claim from Prepared to Downloaded

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Changing the claim to the Downloaded status will remove it from the Unbilled appointments list, so you’ll no longer be prompted to create a claim for the appointment(s) in question.

If you’ve received an Explanation of Benefits from the payer for the claim(s) you've submitted outside of SimplePractice, you can manually add the insurance payment for the dates of service. This will update the claim from the Prepared status to Paid

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