Insurance Essentials is the core insurance billing experience available on all SimplePractice subscription plans. This includes the insurance features practices use today, along with new functionality we’ve added over the past year.
Note: No action is required to continue with Insurance Essentials, our default insurance offering. Beginning October 1, 2026, Insurance Navigator will be available as an optional upgrade.
Below, we’ll cover the features available with Insurance Essentials:
- Primary and secondary electronic claim filing
- Enrolling to receive Payment Reports (ERAs)
- Centralized Billing hub
- Pre-submission claim checks
- Claim rule automations
- Insurance status checks
- Corrected claim workflow
- Simple Invoicing
- Claim notes
Note: These features are available on every SimplePractice subscription plan. You’ll continue to be charged separately for electronically submitted claims and insurance status checks. For more information, see How much does insurance billing cost?
Primary and secondary electronic claim filing
SimplePractice makes it easy to submit claims electronically to all major insurance payers and most smaller ones. Claims can be submitted from a client’s profile, or in batches from Billing > Claims > Appointments to file.
After a primary claim is submitted and processed, you can electronically file secondary claims for clients with secondary insurance.
You can also create and download claims prior to submission if you file them outside of SimplePractice.
Enrolling to receive Payment Reports (ERAs)
Enrolling with payers you submit claims to is highly recommended, as it allows you to receive electronic Payment Reports (ERAs) in SimplePractice. Payment Reports streamline insurance billing by automatically posting insurance payments and updating claim statuses to paid, denied, or deductible.
There is no additional fee for submitting enrollments or receiving Payment Reports (ERAs).
Note: You can also manually add insurance payments as needed. To learn more, see Adding insurance payments.
Centralized Billing hub
The Billing hub allows you to manage insurance and client billing in one central place. Here, you can review outstanding balances, locate payments, and submit claims.
For a full walkthrough of the Billing hub, see Managing client and insurance billing from the Billing hub.
Note: For more detailed reporting, you can review and export insurance billing data under Analytics > Reports. See Understanding your insurance reports.
Pre-submission claim checks
The Appointments to file tab uses pre-submission checks to determine whether an insurance appointment has the information required to submit a claim. Review the Status column to see whether the appointment is Ready to file or has Missing info.
You’ll see Missing info in the Status column if one of the following is missing from an appointment:
- Diagnosis
- CPT code
- Location
- Demographic information
Click Update info to see what’s missing and add it to the appointment’s details.
Claim rule automations
Claim rule automations allow you to customize how claims are populated for different billing scenarios.
Setting claim rules is optional, but recommended if your practice submits claims using different billing information depending on the clinician, insurance payer, office location, or CPT code.
For more information, see Setting claim rules.
Insurance status checks
Requesting insurance status checks can help verify a client’s mental health coverage.
Beginning October 1, 2026, insurance status checks will cost $0.15 per successful check on the Starter and Essential plans. Checks will continue to be included for free on the Plus plan through March 31, 2027. After this date, they’ll be standardized at $0.15 per check across all plans.
Note: When requesting status checks through SimplePractice, the information that’s returned is dependent on the payer. If you aren’t able to verify a client’s benefits through SimplePractice, we recommend contacting the payer directly.
For more information, see Requesting mental health status checks.
Corrected claim workflow
Our corrected claim workflow simplifies resubmitting denied and rejected claims while saving records of past submissions. Click Create Corrected Claim to archive the original version of the claim and create a new one that you can edit and resubmit.
For more information, see Submitting a corrected claim.
Simple Invoicing
When billing insurance, a client’s invoiced responsibility can change after a claim has been processed. Under daily, monthly, or manual invoicing, this results in multiple invoices being created to reflect an appointment’s updated totals.
With Simple Invoicing, each appointment has one invoice that will automatically update to show changes to the total.
For more information, see Using Simple Invoicing.
Claim notes
Claim notes allow you to record information directly in a claim’s history. This is helpful for logging events such as reaching out to an insurance payer or contacting a client for follow-up.
For more information, see Adding claim notes.