Investigating missing Payment Reports

Even if you’ve received the funds for an insurance payment from a payer, an electronic Payment Report for the payment might not be delivered. This can happen if:

• Our clearinghouse received the Payment Report from the insurance payer but wasn’t able to send it to your SimplePractice account successfully
• Our clearinghouse never received the Payment Report from the payer

If you’re missing a Payment Report, first check that you have an accepted Payment Report enrollment with the payer. To do this:

1. Navigate to Settings > Client billing and insurance > Payers
2. Search for the insurance payer
3. Click View Details next to the payer

4. Review the Payment Reports column

• The status should be Accepted

If a Payment Report enrollment doesn’t have the Accepted status, you won’t receive Payment Reports from the payer in SimplePractice. For more information on next steps for each status, see Viewing enrollment statuses.

A Payment Report enrollment must be submitted with the Billing Provider NPI and Tax ID that you have on file with the insurance payer. If the Billing Provider NPI and Tax ID on claims submitted to the payer don't match the NPI and Tax ID on your Payment Report enrollment, the payer won't send Payment Reports to your SimplePractice account.

To review the NPI and Tax ID on a Payment Report enrollment:

1. Navigate to Settings > Client billing and insurance > Payers
2. Search for the insurance payer
3. Click Manage next to the payer
4. Select Manage Enrollment

5. Click Review Enrollment Details

If you need to update the NPI and Tax ID on your Payment Report enrollment to match what’s on file with the payer, see How do I update my enrollment information?

Note: If the Billing Provider NPI and Tax ID on a submitted claim doesn't match the Payment Report enrollment with the payer, the insurance payment for the claim will have to be manually added. For more details, see Adding insurance payments.

If your Payment Report enrollment is accepted and has the correct NPI and Tax ID, we can create a case with our clearinghouse to investigate the missing Payment Report with the payer. For us to open this investigation, submit a help request with the following information:

• The wire/check number for a payment you received from this payer that you didn't receive an ERA for through SimplePractice
• The dollar amount of the payment
• The payment date

If you have an EOB for the payment, please also share this with our team by uploading the EOB to a client’s profile. Then, send us the secure client URL following the steps in Sharing a secure client URL.

Note: If you need to update the Billing Provider NPI or Tax ID being submitted on claims, see Entering your billing information.