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Getting Started with SmartBilling Pro

Note: This guide is intended specifically for customers of our in-house medical billing service, SmartBilling Pro. You can find out if SmartBilling Pro is right for you here: SmartBilling Pro

This guide will walk you through everything you need to know to set up your account so that our in-house medical billing service SmartBilling Pro can start submitting your claims. Following these simple instructions will set you up for success so that they can make sure you never miss an insurance reimbursement again.


Set up your profile

See this guide for step-by-step instructions: Setting up your SmartBilling Pro profile.


Enable Secure Messaging

Your SmartBilling Pro team will communicate with you by using the Secure Messaging feature in your SimplePractice account. First, you must enable Secure Messaging on both the Practice level and Team Member level. To enable Secure Messaging:

  • Go to My Account > Settings > Secure Messaging
  • Switch the button to On to activate Secure Messaging between you and your Team Members.

Note: Clients, clinicians, and contacts can get notifications sooner so that they can respond faster and even chat in real-time. When any user sends a Secure Message and the recipient does not read the message after 2 minutes, a notification email is sent. 

Tip: Secure Messaging is even more convenient when you’re using the SimplePractice app on your smartphone. Get push notifications as soon as you have a new secure message and respond directly from your phone.


Set up your account

First, make sure you’ve entered the following information into your SimplePractice settings:

  • For a solo practice

    • Personal NPI
      • Go to My Account > Settings > Basic Info > Clinical Info and enter your personal (also known as type 1) NPI there.
    • Practice Information
      • Go to My Account > Settings > Practice Details and make sure you fill out your practice name, phone number, address, and multiple office locations (if necessary).
    • Organization NPI (also known as Type 2)
      • Go to My Account > Settings > Billing and Services and enter your Organization NPI here. If you don’t have a Group or Organization NPI, leave this blank and Save.
    • Tax ID or SSN
      • Go to My Account > Settings > Billing and Services and enter your Tax ID or SSN in the Tax ID or SS# field. If you’re using a SSN, enter it in this format: XXX-XXXXXX. If you’re using an EIN, enter it in this format: XXXXXXXXX.
    • Taxonomy Code
      • Go to My Account > Settings > Billing and Services > Insurance and edit the taxonomy code so that you have the correct one on file. If you’re unsure what your taxonomy code is, go to www.npiregistry.cms.hhs.gov and run a search using your NPI so you can find it.
    • Billing Address
      • Go to My Account > Settings > Billing and Services > Insurance and enter the correct billing address (or the address where you’d like the payers to send you insurance payments). Make sure the Individual option is selected unless you are billing as an Organization.
  • For a group practice

    • Personal NPI
      • Go to My Account > Settings > Basic Info > Clinical Info and enter your personal NPI there. For your group practice, make sure every clinician in your account completes this step.
    • Practice Information
      • Go to My Account > Settings > Practice Details and make sure to fill out your practice name, phone number, address, and multiple office locations (if necessary).
    • Organization NPI
    • Tax ID or SSN
    • Go to My Account > Settings > Billing and Services and enter your Tax ID or SSN in the Tax ID or SS# field. If you’re using a SSN, enter it in this format: XXX-XXXXXX. If you’re using an EIN, enter it in this format: XXXXXXXXX.
    • Taxonomy Code
        • Go to My Account > Settings > Billing and Services > Insurance and edit the taxonomy code so that you have the correct one on file. If you’re unsure what your taxonomy code is, go to www.npiregistry.cms.hhs.gov and run a search using your NPI so you can find it. Make sure to use the taxonomy code for your group NPI.
    • Billing Address
      • Go to My Account > Settings > Billing and Services > Insurance and enter the correct billing address (or the address where you’d like the payers to send you insurance payments). 

Note: If your billing address is different from the address where you perform your services, make sure you also turn on the Service Facility Location (Box 32) option.


Set up your client's profile

Make sure every insurance client has all of the required information in their profile. To update this information, go to the client’s Overview page > View/edit client info > Client info tab and enter this information:

  • First and Last name as shown on their insurance member ID card
  • Phone number
  • Address
  • Birth date
  • Gender

Next, you’ll need to enter their insurance billing information. To do this, go to the client’s Overview page > View/edit client info > Billing and Insurance tab and enter this information:

  • Set the client’s Billing Type to Insurance
  • On the Billing and Insurance tab, click +Insurance info and enter the following information for the client:
    • Insurance Type (primary or secondary)
    • Insurance Company
      • Be careful to select the correct payer ID. You can learn more in this guide: How do I find the correct payer ID? Please note that if your client has a Blue Cross Blue Shield plan you should always select the BCBS plan that is local to your area, even if your client has an out of area plan.
    • Member ID without any spaces or dashes.
      • The member ID may also be called the Subscriber Number, Contract Number, or Plan.
    • Client’s Relationship to Primary Insured
      • If the client is under someone else’s plan, make sure you select the option that applies. You also need to make sure that you enter the information for the primary insured in the fields that show up on that page.
  • Upload the client’s insurance member ID card
    • At the bottom of the Insurance Info section, you will see a box that says Front of Insurance Card with a blue document icon. Click Browse to upload a copy of the insurance card or drag the file to this box. 

Note: You can upload either JPEG or PDF files. If you upload PDF files you won’t have a preview option, but you’ll still be able to view the file by clicking it.

  • Scroll down and add Authorization information if it was required by the payer. Here you can enter the prior authorization number, the number of uses, and the dates through which the authorization is valid. Check Active for the authorization to automatically populate on the claims that we will submit.

Note: You can learn more about Authorization Tracking in SimplePractice by viewing this guide: How do I use Authorization Tracking?


Submit your enrollments

Some insurance payers require you to submit an enrollment request in order to allow us to file insurance claims electronically via SimplePractice. Enrolling in claim filing is not the same as being paneled with the payer or getting credentialed. Enrollments simply let payers know that you will be using SimplePractice to file claims and receive Payment Reports (also known as EOBs or ERAs).

There are two types of enrollments: Claim Filing Enrollments and Payment Reports Enrollments.

  • Claim Filing Enrollments
    • If the payer you’re working with requires a Claim Filing Enrollment, we won’t be able to submit claims in SimplePractice until the enrollment has been accepted by the payer. This is essentially a request for permission to the payer to use SimplePractice for submitting claims.
  • Payment Report Enrollments
    • Payment reports are just like EOBs (Explanation of Benefits) or ERAs (Electronic Remittance Advice). They give a detailed breakdown of the insurance payer’s claims reimbursement and indicate which appointment the payment is associated with.

After you have entered your clients’ insurance information into their profiles, you’ll be able to submit your enrollments for any payers that require you to do so. Go to My Account > Settings > Insurance Payers > All Payers and follow the instructions found here: How do I submit an enrollment to file claims or receive payment reports?

Important: Make sure the information in the enrollment form matches what the payer has on file for you. If it doesn’t, the payer will reject your enrollment. After you submit your enrollment, you’ll see its status change to Submitted. We will email you when your enrollment has been completed or if there are any other steps needed from you to complete this process.

What do enrollment statuses mean?

  • Not Required:
    • This is great news! It means you are not required to enroll for claim filing and can start submitting claims right away through SimplePractice, even in your free trial.
  • +Enroll:
    • This means that you will need to enroll with this payer for electronic claim filing (or Payment Reports). Simply click +Enroll and fill out a quick application to start the process. Our clearinghouse will take it from there, and you’ll be notified as soon as the enrollment is accepted.
  • Document Required:
    • The payer requires that you complete additional information for the enrollment to process. Follow the instructions provided in the PDF you receive and complete the steps. If the instructions are not completed entirely, your enrollment will be on hold indefinitely.
  • Payment Reports Not Supported:
    • This payer does not provide the option to receive Payment Reports through SimplePractice. You will need to provide you SmartBilling Pro teammates with copies of your Explanation of Benefits or ERAs. (Please see the Share Documents section below).
  • No Clients on File:
    • You must have at least one client using the payer to enroll. Please add the insurance company to that client’s profile and then return to this page to enroll.

Tip: Remember that even if you're waiting for an enrollment to be accepted, you can still use SimplePractice to create claims, print them, and then submit them by mail to avoid any delay in payment.


Track your claims

Now that you've set up your account and your clients’ profiles, your SmartBilling Pro teammates are ready to submit your claims! You can easily track the claims that they submit as they go from Prepared to Paid right before your eyes.

To do this, go to Billing > Insurance > Claims.

Note: You’ll receive an email each time a claim status is updated.


Check for unbilled appointments

There may be a time when your SmartBilling Pro teammates won’t be able to submit all of the claims on the Unbilled Appointments list. When this happens, it means that they do not have all the information required by payers to submit claims for that client.

To see what information is missing and to be taken to the Client Info page to add the required information, follow these steps:

  • Go to Billing > Insurance.
  • On the Unbilled Appointments tab you’ll see a list of all insurance appointments that do not have claims created. If there is an exclamation point icon next to a client’s name, this indicates that important information is missing.
  • Click the exclamation point icon next to the client’s name to see what information is missing.
  • Clicking Add Missing Info will take you to the Client Info page to update this information for the client.
    • If you’ve filed claims outside of SimplePractice or a client changes from Insurance to Self-Pay, these appointments may still appear on the Unbilled Appointments list. To avoid having these claims submitted in error, you should choose one of these two options:
      • Remove the appointments from the Unbilled Appointments list by changing the individual session to self-pay
      • Let your SmartBilling Pro teammates know that it was already submitted and they will create and download a claim to simply store in your account for your records.

Share documents

Safely and securely sharing documents with your SmartBilling Pro teammates is crucial to making sure you get paid more frequently and that you're spending less time on billing. You can learn about the special process we've put in place for you in this guide: Using Dropbox for SmartBilling Pro customers.


Best practices for working with your SmartBilling Pro teammates

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