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Clearing out claims that are not submittable

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58 comments

  • Elizabeth Gardner

    Hi, I've read through all of the above and tried all of the suggestions and I still can't get three Medicaid clients off of the unbilled appointment list.  So EVERYTIME I log into submit claims I have three clients who I have to uncheck each time.  I do not want to do this for the rest of my use of Simple Practice.  

    For now I have switched them all to Self Pay so until I am able to submit (waiting for Medicaid to approve this) they will no longer show up.  However, I marked their invoices paid - and they still show up.  I deleted the claims - and they still show up.  I deleted the invoices - and they still show up.

    I suppose when I am able to submit my Medicaid claims I can submit and Medicaid will just tell me that they are duplicates but there should be a way to get rid of them (as seen by all the folks above.)  Any more suggestions?

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  • Gillian

    Hi Elizabeth, I'd be happy to help. It sounds like you marked the clients as Self-Pay under Edit Details, but haven't yet adjusted their past sessions to Self-Pay from Insurance. You can do so on the client's Overview > Billing tab. Hover your mouse over the past sessions to reveal the Edit button, then flip the appointment from Insurance to Self-Pay. Let me know if you have any additional questions about this, or anything else SimplePractice. I'm here to help. 

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  • Rick Morris

    Just getting started on SP moved from another system - i have on the Billing->Insurance->Unbilled claims that are showing ready for batch -- BUT we billed these manually and posted the payment from the insurance and applied the copay and the invoice for the DOS shows PAID and all payments from insurance and client are paid and has a zero balance.  How do I get these not to show up on the unbilled appointments list?

     

    - ADDITION - I think i figured it out as noted above in other responses - i really have to click the create the claim and then not submit it.  I'm hoping this does clear itself up with the payments coming in will clear the claim and file it way so i dont see it forever.  Looks like i found my own answer.

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  • Gillian

    Hi Richard, I'm glad that you've gotten this resolved. Let me know if you have any additional questions about this, or anything else SimplePractice. I'm here to help. 

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  • Angela Lancaster

    Hi, 

    I have followed direction from here in which I have prepared claims that were filed external from SP and I have entered the payments but the claim is still marked as prepared and not moved to paid. I also have one claim that was filed through SP marked Accepted which has been paid and payment was entered manually but the claim is still marked Accepted and not Paid. Please advise on how to get these claims resolved. 

    Thank you, 

    Angela

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  • Sharon E. Prager

    Have we found a way to rectify this? If I get paid via check and not through the clearinghouse EFT directly I have a %^&$ ton of claims listed as accepted but not paid. When we add a payment in the system via check can you guys please, please, PLEASE list the claim as PAID??? I do not understand why this is an issue? I saw that you had asked someone why they did not want to leave this open, I can answer why I don't want to- I use that system to correct/call/change/resubmit any open claims for the entire practice. I just want to deal with the claims that have NOT been paid. PLEASE rectify this. 

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  • Gillian

    Hi Angela and Sharon, a member of our team will reach out to you both privately to assist. 

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  • Victoria Kwater

    I am trying to figure this out and no matter what my claim keeps reappearing.  When I was scheduling the person's next session I had accidentally scheduled a second appointment for the same day, which because I did this the day of the appointment it created a duplicate claim.  I had already filed one claim, deleted the second appointment and moved it to the correct date, but the second unbilled appointment continues to show up.  I thought it would be simple to create the claim and then delete it, but no matter what I try it continues to show up.  I just want it deleted so I don't accidentally submit it in the future.

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  • Gillian

    Hi Victoria, happy to help. Our team would be happy to investigate this with you. Please reach out through the ? bubble so the Success team can assist.

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  • Greg Kiper

    It's very simple what we are asking - not getting any answers on this thread.

    How can we delete an unbilled appointment without making a claim - or - how can we delete a claim without submitting it and having it go back to an unbilled appointment. 

     

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  • Gillian

    Hi Greg, to remove an unbilled appointment from the Unbilled Appointments list without creating a claim, you can change the session to Self-Pay on the client's Billing tab. 

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  • Greg Kiper

    HI Gillian - This works for future appointments, unless I'm missing something. Already tried it. I'm not looking to delete something that hasn't happened. Any other ideas?

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  • Gillian

    Hi Greg, you can edit past appointments too. Just hover your mouse over the session fee, click Edit, and flip the appointment to Self-Pay. 

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  • Greg Kiper

    Thanks.  Not seeing where to do this from - Calendar doesn't seem right.

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  • Greg Kiper

    Figured it out. Done  from the Appointment on the Client Overview page. Thanks. Does the trick. If by doing so, it wants to put a charge to the self-pay service, and you don't want that - you simply put $0 in the session fee. Unbilled appt cleared out. 

    Thanks again!

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  • Greg Kiper

    Sorry, mis-info in last post. You do this from the Appointment on the client Billing page.

     

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  • Janet Kago

    Hi,

    I'm having problem in billing Tufts Health. I contacted the Insurance Company (Tufts Health) and they said the problem is with the clearing house. The error message we're getting is that the subscriber is not the primary carrier-which we have the correct client information.Second error message is that I'm not credentialed, and I've not had similar problem with other clearing houses.

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  • Gillian

    Hi Janet, are you courtesy billing out-of-network for these clients?

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  • Elizabeth LaColla

    I too am transitioning from billing in another program and have claims that have been paid.  I entered the payments an write off  and went back and made sure the payments were correctly allocated which they were, but they stayed in my unbilled. I did what you suggested, Gillian, but unfortunately,they are still in my unbilled.  I too would like a clean slate and to have only the claims that I am doing through Simple Practice in there.  It is frustrating, time consuming and just not a clean accurate picture of the situation when there are claims that do not belong.  I love the ease of submitting claims, but have several clients that I currently am submitting on, but also have prior appointments, so each time I have to go in and unclick the ones that have already been billed and have payments allocated. 

    It does not seem like a difficult thing to fix, especially since there are so many requests, Even just an option to hide this claim/ appointment. 

    Thanks-
    Liz

     

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  • Jessica Ruiz

    I have a client who started out as an EAP and I filled those directly through Optum website.  Now the client continues with me and I'm trying to file regular insurance through Simple Practice but when I create the claim all the EAP dates of service continue to appear.  If I try to manually delete them it won't let me submit the claim because it's asking for me to complete filling out the missing information.  How can I get rid of those DOS on the claim form and submit the ones for regular insurance filing? 

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  • Ruth

    Hi Jessica, you'll want to create the claims for all the EAP dates of service before changing the client's insurance information. With the EAP insurance listed as the client's Primary Insurance, go to your Billing > Insurance > Unbilled Appointments. Next to the client's name, you'll see an arrow to the right, click on it, uncheck the boxes next to the sessions that you'd like to bill to their new insurance. Once only the EAP dates of service are checked, click the Create Claims button. This way, you won't be prompted to create or submit claims for these dates of service. Now go to the client's file > Edit > Billing and Insurance and add the new insurance as the Primary Insurance for this client. Navigate back to Billing > Insurance > Unbilled Appointments to Create & Submit Claims for the new dates of service you'd like to bill the new insurance! 

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  • Ariana R. O’Day

    Hello! I have clients who are paying for therapy through Victims Compensation or their work which are not option for "insurance company" without that info it seems like I cannot create claims and then allocate payments when I receive the checks. Any wisdom on how to make claims for these clients so I can record the payments?

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  • Ruth

    Hi Ariana, I'd suggest adding the Victim's Compensation or Employee Assistance Programs as custom insurance payers. To do this, go to Settings > Insurance > Add Insurance Payer and then enter the information for the program. Next, go to your client's file > Edit > Billing and Insurance > +Insurance Info > search for this newly added insurance payer in the Insurance Payer search bar and select it from the dropdown menu. You'll want to add all the required text fields, marked by red asterisks, then hit Save at the bottom of the page. You can now create claims for this client. You won't be able to submit claims to this payer electronically through SimplePractice, but you can print out the claim and mail it to them, then enter the payments you receive from them. These guides goes into more detail about how to bill an EAP through SimplePractice: Adding an EAP and Entering an EAP Payment.

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  • Michelle Hamilton

    I'm confused as to why they would not convert to "PAID" once a payment has been entered, rather than left showing as "prepared" or "un-billed." I use a free claim submittal site for a few insurances, yet the activity does not match up when entered manually. 

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  • Ruth

    Hi Michelle, when a manually entered insurance payment doesn't update the claim status to "Paid" it often means the amount entered for the "Insurance Paid" + "Client Owes" + "Write-Off" doesn't equal the amount billed for each service listed on the claim. I'd recommend reaching out to our Customer Success Team by using this link to submit an email Help Request so they can look into your account and investigate this specific claim for you. 

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  • Nicole Bennett

    Is there a way to indicate a write off so that these are applied to the tax information? Deleting it doesn't keep a record of the time spent and the deduction for the write off. There used to be a really simple, straightforward way to do that. 

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  • Ruth

    Hi Nicole, you can enter a write off in when you add a manual insurance payment for insurance pay sessions. For self-pay sessions, you can go to the client's file > Billing tab, click on the appointment in question to edit it and add an amount in the Write-Off text field. Check out these guides on Adding Insurance Payments and Changing the fees for an appointment, which will help you with adding a write-off for self-pay appointments. 

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  • Gillian

    Hi Stephanie, you can create, but not submit, claims for these sessions to remove them. Then, add the payments from your payers to mark them as paid. 

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