Claims submission
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A claims shows submitted on Simple practice but the insurance company does not have record of it. What do I do?

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    Mike

    Hi Fatima,

    We'll need to open a case with our clearinghouse to investigate this issue. In order to do that, we'll also need some additional information from you.

    First we'll need the secure claim URL to identify the claim in question. This is the address in your web browser's address bar when you are viewing the claim.

    Although I believe that you have already called the payer, can you please call the payer one more time (make sure to speak with a live representative) and give them the member ID and the dates of service listed on the claim in question? Because the claim has been submitted this information should be sufficient for them to locate the claim within their system and provide you with more information about its current status.

    If the payer is still unable to locate the claim, then it will be very important to obtain the following information:

    The phone number you call.
    The name of the representative you speak with.
    The call reference number.

    This information will enable our clearinghouse to call the payer directly about this claim and investigate further. Without this information, our clearinghouse will not be able to take further action.

    Once we receive that information, my colleagues on our Insurance Team will be able to investigate.

    I will reach out by email and you can provide the information about the phone call there.

    Hi Fatima,

    We'll need to open a case with our clearinghouse to investigate this issue. In order to do that, we'll also need some additional information from you.

    First we'll need the secure claim URL to identify the claim in question. This is the address in your web browser's address bar when you are viewing the claim.

    Although I believe that you have already called the payer, can you please call the payer one more time (make sure to speak with a live representative) and give them the member ID and the dates of service listed on the claim in question? Because the claim has been submitted this information should be sufficient for them to locate the claim within their system and provide you with more information about its current status.

    If the payer is still unable to locate the claim, then it will be very important to obtain the following information:

    The phone number you call.
    The name of the representative you speak with.
    The call reference number.

    This information will enable our clearinghouse to call the payer directly about this claim and investigate further. Without this information, our clearinghouse will not be able to take further action.

    Once we receive that information, my colleagues on our Insurance Team will be able to investigate.

    I will reach out by email and you can provide the information about the phone call there.

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    Michele Harris

    Michele Harris <michele@wowcounseling.com>

    12:58 PM (1 minute ago)
     
     
     
     
    to SimplePractice
     
     
     
     
     
     
     
    Hello,
    This has happened on more than one occasion. I just got two emails from your company stating the Status as Denied. I call UHC to find out why the services have been denied and they report that I will indeed be getting paid. Why does this keep happening? I waste quite a bit of time calling them to address this issue. They assure me that they aren't saying the claim is denied from their end and can't figure out why the SimplePractice clearinghouse is doing so.
    From,
    Michele Harris
    208-602-6130
     

    On Mon, Mar 30, 2020 at 6:01 AM SimplePractice <yourteam@simplepractice.com> wrote:

    Hi Michele Harris,

    The payer has denied the following claim. You can get additional information from the payment report or you can contact the payer directly.

    Our support team doesn't have the ability to provide more information for denied claims.

    Status Denied
    Amount $160
    Payer (ID) 87726 Optum See UHC/UB... ()
    Submission Date 03/20/2020
    Service Lines 1
    Clearinghouse Reference # XG0HLH8BDIIS4
    Payer Claim # 932200804172900

    Michele Harris <michele@wowcounseling.com>

    12:58 PM (1 minute ago)
     
     
     
     
    to SimplePractice
     
     
     
     
     
     
     
    Hello,
    This has happened on more than one occasion. I just got two emails from your company stating the Status as Denied. I call UHC to find out why the services have been denied and they report that I will indeed be getting paid. Why does this keep happening? I waste quite a bit of time calling them to address this issue. They assure me that they aren't saying the claim is denied from their end and can't figure out why the SimplePractice clearinghouse is doing so.
    From,
    Michele Harris
    208-602-6130
     

    On Mon, Mar 30, 2020 at 6:01 AM SimplePractice <yourteam@simplepractice.com> wrote:

    Hi Michele Harris,

    The payer has denied the following claim. You can get additional information from the payment report or you can contact the payer directly.

    Our support team doesn't have the ability to provide more information for denied claims.

    Status Denied
    Amount $160
    Payer (ID) 87726 Optum See UHC/UB... ()
    Submission Date 03/20/2020
    Service Lines 1
    Clearinghouse Reference # XG0HLH8BDIIS4
    Payer Claim # 932200804172900
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    Gillian

    Hi Michelle, because this is specific to your account and the claim, we'll reach out to you privately to assist. 

    Hi Michelle, because this is specific to your account and the claim, we'll reach out to you privately to assist.