Claims filed outside of SP
AnsweredA claim was created and downloaded in SP. Claim was faxed to Payer. Will SP automatically update a claim in Downloaded status when it receives a payment report? If the payment information is entered manually from the EOB , will this create a problem later when payment report is received by SP?
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Hi Wanda, if your Payment Report enrollment was accepted prior to you submitting the claim, they you might not need to manually enter the payments for this faxed claim. If you're still waiting for your enrollment to get accepted, then you'll need to manually enter the payments from your paper EOB. Payment Reports will only auto-populate payments for claims submitted after your enrollment was accepted. If an electronic Payment Report doesn't automatically update the status of a claim in your SimplePractice account to "Paid," then it may contain different billing information than then claim you submitted, or the system may've not recognized that the payment corresponds to the claim submitted outside of SimplePractice. The best way to automate your insurance bookkeeping with Payment Reports is to submit your claims electronically through SimplePractice as well. You can always reach out to us by submitting an email Help Request if you need more help balancing your client's insurance billing!
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This question and response are helpful for an issue I'm facing. I recently hired a biller b/c I no longer have the time to track down insurance companies for randomly denied claims. However, now all my claims will be submitted outside SP. I have lots of Payment Report Enrollments with the various insurance companies I work with. My understanding of the conversation above is that if those enrollments were already established, my EOBs will continue to automatically populate in SP even though claims are now being submitted through a different clearinghouse? Is this correct?
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