EAP sessions stuck on "unbilled appointments" page
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I enter EAP as insurance rather than self pay because the patient is not the one to pay the "insurance" is. Then my EAP sessions are on the "unbilled appointments" page forever. Please fix this or give us a way to delete stuff off that page.
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I figured it out! For EAP sessions that have already passed- if you had it listed as insurance then it will show up on this list, but if you go in to the client's page and under the billing tab: find the date the claim is trying to be created for, click the Edit underneath the amount related to said date, and change it over to self-pay for those days. This will clear it off the list and if you put $0 for what the client owes then it's all good.
Ultimately it doesn't solve the problem of keeping track, but I found this successful for my use case as I don't use Simple Practice to submit my EAP sessions, I submit directly through the EAP provider website.
Hope this helps you Rhonda!
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Meghan, that's a great workflow to follow. Please do note, however, that if you'd like to record EAP payments in SimplePractice you will not be able to allocate said payments to sessions that are marked as Self-Pay. Every practice is different, so the workflow that works best for you is the best one to follow!
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Hi Catherine,
What Meghan is suggesting is to change these EAP appointments from Insurance Pay to Self-Pay, so that they do not appear as "Unbilled Appointments" in your SimplePractice account.
To do this, first delete any invoices, Superbills or Statements associated the appointment. Then, locate the client (by searching by name or selecting the client name from the left navigation bar), and click the Billing tab. Click Edit located below the appointment amount (hover your mouse over the appointment to make Edit appear, as shown below).
Rather than changing the session type from Self-Pay to Insurance as in the GIF above, change the session type from Insurance to Self-Pay and click Save. You can visit our Help Center article on appointment level billing changes for more details.
As Gillian mentioned above, this workflow will prevent you from allocating EAP payments to sessions that are marked as Self-Pay. If you want to track these EAP payments within SimplePractice, you will need to keep these appointments listed as Insurance Pay, then add the employee assistance program (EAP) to your list of insurance providers then enter an EAP payment much in the same way that you would add an insurance payment. If the EAP pays you with a prepaid credit card insurance, follow the directions on adding a prepaid credit card insurance/EAP payment to that client's account.
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Is there any reason not to submit an EAP claim through Simple Practice? I am currently trying to figure out the most efficient tracking method for all payments and it seems that submitting everything through Simple Practice is the only way to get accurate billing reports and payment tracking?
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Marc - I submit EAP claims through SimplePractice all the time. As long as the EAP is listed in the provider list for SimplePractice, it's do-able. Usually there is a little manual adjustment, such as adding a modifier with the CPT code, or creating a CPT code for yourself that doesn't otherwise exist that the EAP uses only for those sessions.
Unless it's a provider that shares claim info back to SimplePractice, you'll still have to do the reconciliation manually to record payments made. For example, I get United Healthcare updates via SP, but other EAPs typically don't have the two-way communication with the software.
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Marc, several of my EAP companies require me to sign in directly with their portal and submit that way (i.e. Espyr, Workplace Options, Morneau Shepell... each have their own tedious portal requirements), while others require me to submit PAPER claims for their EAP clients and will not accept any electronic clearinghouse claims (i.e. Anthem EAP...). That is why I cannot submit them directly through the Simple Practice portal.
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Pamela, you can delete the claim form, collapse the date range on the client's Billing tab to just the sessions that you want on the claim, and then recreate it. For EAP sessions submitted outside of SimplePractice, create a claim, but do not submit it, to remove these sessions from your Unbilled Appointments list.
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I think Simple Practice needs to make a section for EAP charts. I mean have a place developed in the ERH specifically kind of like psychotherapy notes and develop the billing into that section. EAP charts should be kept seperate from your other charts anyway according to the Employee Assistance Professionals Association. This way if the EPA allows you to continue seeing them under insurance than you can switch to the regular part of the ERH. Either way, there needs to be a place built into the system for EPA billing for sure.
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I'm having a similar problem because the EAP I am credentialed with pays for a few late cancelled sessions. Once an appointment is set to Late Cancelled, it doesn't show up in my Add Insurance Payment queue so I cannot allocate the insurance payment to it. To get around this, I listed the appointment as Show, allocated the payment, and then changed it back to Late Cancelled. Now it shows that the client owes out of pocket when the client does not. Is there any way to change this? Or does the program assume that a Late Cancelled appointment is always charged to the client and insurance or EAP would never pay for it?
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Jocelyn - I'm not sure if there's a better solution, but I created services that I can assign in the appointment for situations like this. For me, it was late cancellations and no-shows, so I added "CANC - late cancel or no show, first occurrence" and "LCAN - late cancel or no show, more than one occurrence". Clients don't get assigned a missed appt fee the first time it happens, but do after that. Obviously these aren't services available to be booked online - just something I can choose in the service list when I'm changing the status of the appointment. Obviously I can't submit either on a CMS 1500, but I can create invoices or forms and just not submit them.
Hope it helps!
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Thank you Heather. I tried that but I am still having an issue allocating an insurance payment to the balance for the client. When I want to add an insurance payment, the session does not show up because it is Late Cancelled. I don't want to change the status to Show because the client did not show. I'm hoping Simple Practice can institute some sort of fix for this because it seems to be happening to several of us.
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