SimplePractice Support
SimplePractice Services For Psychiatry, PMHNP, Psychology, And Behavioral Health Practices.
We run billing inside SimplePractice for behavioral health practices. Every claim there is built from the appointment, so that’s where we start, then we match what’s billed to what the note supports, follow up with payers on unpaid claims and show you where the money actually stands.
Why AdvanceAPractice
What We Bring To SimplePractice Billing
Behavioral Health Billing Experience
Our work is built around psychiatry, PMHNP and psychology billing, and the payer rules that decide what those visits pay.
Every Claim Starts On The Appointment
A claim’s only as clean as the steps before it. The appointment, the note, the code and the submission all have to agree before it goes out.
Denials, Telehealth And Credentialing As One Job
Denials, telehealth workflows and credentialing feed each other, so we work them as one system instead of separate headaches.
Where Behavioral Health Billing Gets Complicated
Where Behavioral Health Claims Go Wrong Before They Pay
Plans Set Their Own Limits And Rules
Visit limits, service types, telehealth rules and authorization requirements vary from plan to plan. Medicaid and Medicare-related workflows add their own.
Notes, Codes And Billing Have To Line Up
When the diagnosis, the medical necessity language, note timing and service details don’t line up with the billing workflow, claims get harder to submit clean. They’re harder to defend, too.
A New Provider Who Can’t Bill Yet
Enrollment, panel participation and billing readiness delays hit hardest when a practice is growing. A new provider who can’t bill yet still has to be paid.
What We Check
What We Check On Every SimplePractice Session
We fix the steps that decide whether a session pays. We check eligibility and benefits, set telehealth place of service and modifiers on the appointment, and make sure every documented session reaches a claim. Then we work denials, patient balances and aging accounts, and we’ll track authorizations where a payer requires them.
- Eligibility and benefits checked by service type before the visit, not after the denial
- Authorizations and concurrent reviews tracked where a payer requires them, so a session doesn’t go out on an approval that’s run out
- Telehealth place of service and modifiers set per payer, since one default won’t be right for every plan
- Psychotherapy add-on codes billed with a med-management visit, checked against the note before the claim goes out
- Denials appealed while the appeal window’s still open, and aging A/R worked claim by claim
- Patient balances that match the remittance, so a client doesn’t get a bill for what the plan should’ve paid
- Credentialing and payer enrollment tracked together, so a new provider doesn’t fill a schedule before they can bill for it
Behavioral health billing keeps changing. When Medicare started letting MFTs and MHCs bill independently, billing and enrollment workflows changed for a lot of organizations, and payer rules on behavioral health telehealth and integrated care still need careful handling. Each change like that has to reach your enrollments and your appointment defaults before the next claim goes out.
Beyond The Software
What Keeps Changing Around Your Claims
Shared Care Means Shared Data
When a client’s care is shared with another office, the insurance details and the diagnosis have to come across intact. If either arrives wrong, the claim goes out wrong.
Electronic Transactions Need A Clean Routine
Eligibility checks, claim status, provider data and the other standard electronic transactions only save time if the practice has a clean workflow around them.
Provider Type Rules Keep Shifting
As billing rules change for different behavioral health provider types, the enrollment, the system setup and the claims all have to keep up. If one lags, revenue stalls.
Best-Fit Practices
Who We Fit Best On SimplePractice
We’re the strongest fit for psychiatry practices, PMHNP teams, psychology practices and behavioral health groups that already know denials, telehealth problems or inconsistent documentation are cutting into collections.
- Practices where an unpaid claim sits until somebody happens to notice it
- Psychiatry and PMHNP practices billing med management with a psychotherapy add-on in the same visit
- Behavioral health teams whose telehealth place of service or modifier depends on who scheduled the visit
- Growing practices where a new provider can start seeing patients before anyone’s set them up to bill
SimplePractice Billing
How Billing Works Inside SimplePractice
SimplePractice puts scheduling, documentation and billing in one system, with a built-in clearinghouse that sends electronic claims to payers and brings back electronic remittance advice (ERA). Set up right, a completed appointment turns into a submitted claim with relatively few manual steps. That depends on enrollment and setup you’ve done before the first claim goes out.
Claims come from appointments, so whatever’s on the appointment lands on the claim. Get the client demographics, insurance details, place of service and CPT codes right there and the claims come out clean. Miss one and you’ll get a rejection or a denial.
Payer & Provider Enrollment
Electronic claims and ERA usually need enrollment with each payer, for each rendering provider. With several clinicians and several plans, that’s a lot of enrollments to track, and until each one’s approved, those claims and remits can’t move electronically.
ERA & Electronic Remittance
ERA brings payment and adjustment details back into the system so payments post against the right claims. Until ERA enrollment’s done, remittances can come on paper. Then somebody’s posting them by hand, and it’s harder to see what a payer actually paid against what you billed.
Enrollment Delays Stall Reimbursement
Payers control enrollment approvals, and they take time. While one’s pending, claims can sit unsubmitted or go out through slower channels, and your money waits. Tracking every enrollment to completion is one of the most overlooked things a new or growing practice can do for its cash flow.
Claims Built From Appointments
Every claim starts as an appointment on your calendar, so the appointment is the source of truth. Check insurance, place of service, modifiers and CPT codes when you schedule the session and again once you’ve documented it. Do that and the claim’s less likely to bounce back.
Where Claims Get Stuck
Common Pain Points
SimplePractice itself usually isn’t the hard part. Most of the billing friction comes from payer rules, enrollment and follow-up, and the same handful of issues account for a big share of unpaid or delayed claims in behavioral health practices.
Rejected Vs. Denied Claims
A rejected claim never made it into the payer’s system. Usually it’s a formatting or data error you can correct and resubmit quickly. A denied claim was processed and not paid, often because of eligibility, authorization or coverage rules. Those need different fixes. Treat them the same and you waste time.
Enrollment & ERA Setup
When claims won’t go out electronically or remits won’t post on their own, an unfinished payer or ERA enrollment is a common cause. Every payer and provider pair needs its own. It’s easy to lose track of which pairs are live, which are pending and which nobody’s started.
Secondary Claims & Coordination Of Benefits
When a client has more than one plan, the primary payer’s payment has to post before the secondary claim goes out, and coordination of benefits has to be right. It’s fiddly to get the order, the balances and the supporting detail right. Miss something and a legitimate secondary balance goes unpaid.
Reconciling Payments & Telehealth Billing
Posting payments, catching underpayments and reconciling billed against paid takes steady attention. Telehealth adds a layer. Place-of-service codes and modifiers for virtual sessions vary by payer and change over time, so what one plan accepts, another may reject.
Payer rules, enrollment steps and SimplePractice features vary by plan and change over time. Ask each payer, and SimplePractice, what’s current before you rely on a specific setup.
Knowing When
When To Bring In A Billing Partner
Plenty of practices run their own billing in SimplePractice just fine, especially early on. As you grow, it’s fair to ask whether billing is still the best use of your clinicians’ and your staff’s time. These are the signs it’s starting to strain.
- You’re adding clinicians or payers, and the enrollments and claims are outgrowing the time anyone has to manage them.
- Denial and rejection rates are creeping up, and resubmissions are slipping through the cracks.
- Accounts receivable is aging, with more balances sitting in the 60-, 90-, and 120-day buckets than you’re comfortable with.
- Providers or office staff are chasing claims and posting payments at night.
- No one clearly owns follow-up, so unpaid claims quietly accumulate.
We work inside your existing SimplePractice account, and we don’t replace anything. Your team keeps the scheduling and documentation habits it already knows, and we take over enrollments, claim scrubbing and submission, payment posting, denials and aging A/R. That’s our Ongoing Billing, priced by practice size from 7% of collections for a solo provider down to 4.5% for 26 or more providers (see billing prices by practice size). The monthly minimum is $300 for a solo practice. If the trouble is setup rather than volume, an Automation Program builds one workflow from start to finish in your own systems, like a tracker that shows which payer and provider enrollments are live, pending or never started, for $5,000, or five monthly payments of $1,000.
FAQ
Frequently Asked Questions
Do I Need To Enroll With Payers Before I Can Send Claims In SimplePractice?
In most cases, yes. Electronic claims and ERA usually need enrollment with each payer, for each rendering provider. Some payers take claims with little setup and others want approval first. The specifics vary, so it’s worth checking each payer’s current requirements and finishing enrollment before you rely on electronic submission.
Can A Billing Partner Work Inside My SimplePractice Account?
Yes. It’s how we work. You don’t move to a different system, and your clinical and scheduling routines stay the same while we handle claim submission, payment posting and denial follow-up inside your existing SimplePractice account. We’ll agree on the exact access up front and keep it in line with your privacy and security obligations.
How Does Telehealth Billing Work In SimplePractice?
Telehealth claims come from appointments like any other session, but they often need specific place-of-service codes and modifiers to show the service was virtual. Those requirements differ by payer and change over time. One configuration won’t be right for every plan. Confirm each payer’s current telehealth rules and set them on the appointment so they carry onto the claim.
When Should I Outsource My Billing?
It’s worth a look when the practice is growing, when denials or aging receivables are climbing, or when providers and staff are giving claims time that should go to patients. There’s no single threshold. It depends on your volume, your payer mix and how much billing work your team can keep absorbing. Many practices revisit the decision as they add clinicians or payers.
What Would Fixing It Cost?
Ongoing Billing, Automation Programs and the Operations Partnership each have a published price and a written scope. Tell us what keeps going wrong, and we’ll point you to the right one.