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Auto-enter zero dollar payments from ERAs

Answered

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3 comments

  • Official comment
    Mike

    Hi John, 

    I'll be happy to clarify this feature of SimplePractice. When an insurance payer chooses not to pay for a claim, this will usually require your attention so you can determine whether there was an error that can be fixed with a corrected claim. If you choose to accept the denial and enter a write-off, it will cause the claim to be marked Paid because SimplePractice understands that you are not expecting any further payment from the payer. 

    Automatically adding a write-off for $0 payments would result in claims that were not Paid being automatically updating to Paid status. This could prevent you from reviewing the claim in a timely manner and deciding whether or not to resubmit a corrected claim, and potentially result in clinicians missing out on revenue. For this reason, we are unlikely to develop a feature to automatically enter write-offs for $0 insurance payments without other enhancements to bring non-payments to your attention. 

    If you have ideas for other ways this could be addressed, we would encourage you to add them to our Ideas and Suggestions board.

    If you're curious, here's more information about how a customer idea can become a SimplePractice feature: Customer feedback: How a customer idea can become a feature in SimplePractice.

    If you have questions, please reach out to us and we'll be happy to help.

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  • Beverly Holze

    We are reviewing billing before we purchase a subscription to SP. This answer concerns me. When an insurance payor does not pay a claim because a patient's deductible has not been met, is the $0 paid automatically entered? This isn't a write-off. The balance minus the in-network contracted discount should be transferred to patient responsibility. 

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  • Gillian

    Hi Beverly, I'd be happy to help. If an insurance payer chooses not to pay a claim because the patient's deductible has not been met, the claim status will update to Deductible, a $0 payment will be recorded, and responsibility for the contracted amount will shift to the client. Let me know if you have any additional questions about this, or anything else SimplePractice. I'm here to help. 

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