SimplePractice Billing Services

SimplePractice is built for independent therapists, counselors and behavioral health groups, and its insurance tools are good at getting a claim out the door. What happens after that — the rejected enrollment, the denial, the Payment Report that never arrives — is still somebody’s job. In most solo and small-group practices that somebody is the clinician, after the last session of the day.

Enrollment comes before every claim, and it is per payer

To file claims electronically and to receive Payment Reports — SimplePractice’s name for ERAs — a practice submits an enrollment for each payer through SimplePractice. Being credentialed with the payer is a prerequisite, not a substitute. Enrollments come back rejected, or sit at a status that needs more information from the payer, and until a Payment Report enrollment is accepted, insurance payments do not post automatically. Someone has to enter them by hand.

One rejection catches practices off guard: a Payment Report enrollment can be refused because the payer is already sending ERAs to another clearinghouse — typical after a switch from another system or another biller. We audit every payer’s claim and Payment Report enrollment, resubmit what was rejected, work the payer-side steps that SimplePractice cannot complete for you, and keep the list current as you add payers and clinicians.

Rejected and denied are different problems

A rejected claim was stopped before the payer adjudicated it, usually for a format, identifier or enrollment problem. A denied claim is a payer decision. SimplePractice can help with the first; for the second, its own guidance is to contact the payer directly. That is the point where software stops and billing work starts: calls, corrected claims, reconsiderations and appeals.

We work rejections the same day and denials within 48 hours. Claims that sit at accepted or received with no payment are followed up at 25 to 30 days rather than discovered at 90. See denial management and A/R follow-up.

The Unbilled appointments list is where sessions go missing

Every session that has not become a claim sits on the Unbilled appointments list. In a busy practice it is cleared in bursts, or appointments are removed from it to tidy the view, and some sessions that should have been billed never are. Nothing about an unbilled session ages or alarms; it is simply not in your A/R.

We reconcile the calendar against claims every week. Each completed session becomes a claim, a documented self-pay visit, or an explained exception. On a first engagement this is often where the first recovered money comes from.

The behavioral health rules SimplePractice cannot apply for you

Software can put the right fields on a claim. It cannot know that the member’s mental health benefit is carved out to a separate behavioral health company, that the plan authorized twelve sessions and this is the thirteenth, or that a payer wants a different telehealth place of service and modifier combination from the one in your default settings. Those are the reasons therapy claims deny, and they are decided before the claim is created.

We verify benefits and carve-outs before the visit, track authorized sessions against sessions delivered, check that documented time supports the psychotherapy code billed, and keep telehealth settings correct per payer. The detail is on our behavioral health billing page.

Credentialing every new clinician before the first session

Group practices grow by adding clinicians, and every new clinician needs to be credentialed and enrolled with each payer before their sessions can be billed. Retroactive effective dates are the exception, so sessions delivered while an application is pending are often unbillable to that payer. Medicare has also enrolled marriage and family therapists and mental health counselors since January 2024, which opened a payer many counseling practices had never billed.

Credentialing and enrollment are included at no extra charge, and we tell you plainly when a panel is closed. See credentialing and the credentialing guide.

What you keep, and what you can check

You keep SimplePractice, your client records, your notes and your subscription. We work as a team member on your account with the access you assign, under a signed Business Associate Agreement. Each month you receive a Practice Performance Report at no charge — claims filed, paid and outstanding, denials by reason and dollars, days in A/R — and you can check every figure against SimplePractice yourself.

Insurance verification, coding review, credentialing and patient statements are included rather than billed as extras. Compare the numbers in in-house vs outsourced billing and pricing.

Why practices on SimplePractice choose Synergy

You keep SimplePractice. You keep your logins, your templates, your schedule and your data. Nothing is migrated and nothing new is purchased — we work inside the system you already run. What changes is who works it: a 98% clean-claim rate, claims out within 24 hours, denials worked within 48 hours, insurance aging worked at 25–30 days, and free insurance verification, coding, credentialing and monthly Practice Performance Reports. Twenty years in business, a US and India team so your queues move overnight, HIPAA-compliant throughout, a 30-day free trial and a 90-day money-back guarantee. We're not your billing service — we're your Billing Department.

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