Name: The Billing Brief
Uploaded: 2026-09-23T18:15:08.618Z
Duration: 37 min 37 s
Description: The Billing Brief

Transcript for "The Billing Brief": welcome. Welcome again to the billing brief. My name is Shazad Moyes. I'm a VP of product here at SimplePractice, and we're excited to to talk about what's new, at SimplePractice in the billing world. As always, I I bring my friends with me. So if I can invite, if I can invite the team on stage for a quick round of introductions before we get into today's, today's content. So, Maggie, if you wanna start? Sure. Hey, everyone. I'm Maggie. I'm a senior product manager here at SimplePractice. I work primarily on our insurance claims, so the overall claim process from start to finish, and really excited to chat with you all. It's fun to see where everyone's located. I saw someone from Astrobula, Ohio. It's really close to where I went to summer camp. So small world. But, yeah, good. Happy to get into it. Scott, if you wanna go next. Sounds good. Hi, everybody. My name is Scott Hare, also senior product manager here at SimplePractice. I work on the insurance foundation team, so covering basically any of the work that's supporting our our insurance billing across across RCM. This is my first billing brief, so I'm excited to chat with you all. Thank you, Scott. Dylan? Hey, everyone. It's great to be with you today. I'm Dylan O'Harek, director of revenue operations here at SimplePractice, and I've been supporting folks like you for the last twenty five years. So you can consider me your advocate on the inside. Great to go through things with you today. Thanks. And last but, of course, not least, Jordan. Hey, everybody. I'm Jordan. I am senior manager here, at some practice for our customer success and support teams, and I work with all of our insurance support teams. So I see lots of your inquiries to us. Excited to be here today. Great. Thank you, guys. And we've got an exciting agenda for you. I'm calling you out of Nashville today, since everyone's sharing their location. And like I said, second episode of the billing brief, and and we're excited to spend the time with you. As a reminder, this is our new monthly livestream. So, hopefully, some of you joined us in August, and we're gonna continue we're gonna continue this as long as you're interested and engaged, and, we're gonna make sure we find the right topics to cover with all of you. Why are we doing this? I think, fundamentally, we know billing is hard. We know insurance is hard, and we know it's complicated. And we are spending our time thinking about how we can make it easier for you to manage and less time consuming so you can focus on what's really important for you, which is running your practice. Our goal here is to create a regular forum for answering questions, being open and transparent, and really showing you behind the curtains of what we're building. Some things we might talk about are new products and features we've just launched. Some might just be topical based on questions we're hearing from you, and some might just be, you know, what's going on in the insurance world at large. And we'll try to make sure the content is relevant and engaging. And, hopefully, through your feedback and questions, it'll help inform us of of what we wanna cover next. In August, I think we I think our last episode was early August. We, we demoed a few features that were on the horizon called the billing hub and and claim automation rules. And since then, we've actually announced the launch of insurance essentials and insurance navigator. And, hopefully, you guys are using and seeing some features from it, and we've we covered those in a few different forms now. We got a lot of questions on, like, how these work. We know and we appreciate that it's a big change, for many of you, and we wanna we were trying to ensure we give enough time and and space to answer those questions. So now that you we we talked about it kind of in August, You you probably had it for about a month now and are using it and engaging with it. And so we wanted to kinda revisit some of those changes. So we will cover we'll cover we'll cover those features that we just launched and and give you a sense of how to use them, and ideally try to address some of the frequently asked questions. And then we'll make sure we save time at the end, to share some best practices. Dylan, who who has mentioned has been in this world for for a very long time, will share some best practices from him as his experience in billing and specifically within simple practice. And as always, we'll make sure we save enough time at the end for for questions, that that you have. So, I'd like to start. I'll I'll welcome Maggie, back up on stage if you wanna join me, Maggie. And let's start with the billing hub. What's, what's new and what's happening in the billing hub? Cool. So I'm gonna share my screen. I'm gonna walk through some of the changes in the account. And, as we go through this, I'm also gonna talk about some things that are to come. So give me a moment. Okay. Great. So you should see a familiar screen here. We'll start with our simple practice home screen, and the biggest change you'll have noticed is our new billing area here. So there used to be separate insurance and billing. The reason we decided to bring those together into one is we wanted to create the most streamlined experience for you to manage getting paid. So managing your client payments as well as insurance payments all here in one section. So I'm just gonna do a quick tour, and then I'm going to, demo quickly the new corrected claim workflow for everyone here, and then we'll move into some questions about corrected claims and best practices around there. So we'll start with the top here. The what we've done is pulled in your settings for billings that you can easily jump and see what is, what is established in your account. So you can see for this fake account, we have daily invoicing set up. We made your claim filing information easy to access here so that you can jump right into seeing what information is going to be represented on your claims. We've also aggregated all of the payers that you're enrolled with. So if you're managing enrollments, if you are in the process of checking enrollments or changing enrollments, you can jump right to them from here. And then lastly, we have our new feature here, claim rule automation, which you can see we have enabled in this practice. And here, you can jump right in to, make changes and add new claim rules. And I'll get to claim rules in just a minute, but I wanted to keep scrolling down the page. So our top section of this new dashboard is to, put together here to pull in your most important tasks, that to start your day with or to help manage your billing. So we default to a thirty day frame, but you can change your time filter here. You can also filter by clinician if you're in a group practice, if you're the account owner or biller. And, what we've done is pulled in your high level tasks, so, claims and unpaid appointments. Those being the two the two most important elements that you wanna tackle in billing. So you can jump right to your appointments that are ready to file straight from here. So we can see we have three clients that have 10 appointments. That represents a little over $1,500 for the practice, and if I jump here, I'm right on the page I need to be to get these submitted and out the door. Now if we go back to our dashboard, we also have we also keep track of the clients and appointments that are missing information needed to bill insurance, so if I jump here I can see all of these clients that I'm not able to create claims for. I can address those right here. If it's an appointment related issue, I can jump right here and update the information directly from this page now. So if it's related to the service code or the diagnosis, maybe it's we're flagging it as invalid, we can update that right here. And if it's something with the client's demographics, let's say we're missing a date of birth or the sex address or member ID, we can jump right to the client's profile from here and make those changes. The next new item I wanted to go over is our unpaid appointments. So we now have the ability to aggregate all of your unpaid appointments within this time frame, and we've created a new page that was inspired by the most used report by and far in simple practice, which is our appointment sessions report. And what we've done on this page, if we go here, we can see a list of all clients who have unpaid balances, and it's every single appointment. And every single service code, we've put that here, and you can take action directly from this page. So you can create an invoice or add a payment directly from this page. You can also look at all payment statuses. So if you want to see, the details by insurance unpaid, you can filter by insurance payers, you can filter by client and filter by clinician here. We've also created a new view where we've aggregated all of your clients and shown all of their balances here. And then moving along the dashboard, we also give you a glimpse into your payments for the month from clients and insurance, and you can jump right here into viewing all of your insurance payments. Here's where you can manage your insurance payments and add manual payments where necessary. Same thing with client payments, we'll take you to a list of all of your active client payments. And then another feature that I'm really excited about is this new claim tracker. So you can see for the month where your claims are, how many are paid, how many are still in progress or action required, denied, rejected. And, again, you can filter the time here so you can look for the year, whatever is relevant to your practice, and then we've aggregated your activity here for all billing. Now you see some, green here representing our, premium features. So we have a new premium feature called insurance navigator that unlocks some additional benefits within this page. First and foremost is the ability to do automatic verification of benefits. So we will automatically check your clients benefits and track that information here for your upcoming appointments. So for any appointments in the next week, we can see here how many clients have been confirmed active, how many are unknown, and how many are active, and we can jump right to your client list to see the information from that plan. The other feature that is new for insurance navigator customers is the claim assistant feature where I'll show you just a quick example. If you have a claim that is rejected or denied, oftentimes, it comes with this code that is, a little mystifying and confusing or maybe not, maybe not very clear, on initial glance. So we've created a claim assistant that will translate your code, tell you what it means, and then give you recommended steps to take. And again this is all available with our new insurance navigator where we are trialing customers right now, so if you're interested in trialing, you should be able to sign up directly from your account, otherwise reach out to support and we can give you instructions on how to sign up for Insurance Navigator. Okay so that's everything I wanted to cover in the dashboard. Now really quickly I'm gonna go over corrected claims since this is a new workflow for everyone. So previously, we would recommend if a claim got denied or rejected and you needed to change something on the claim to submit a new claim, you would have to delete the claim and start over. You may have noticed a change in your account where we no longer recommend deleting the claim. In instances where a claim can be edited directly, we recommend editing on the claim form as you would. So a lot of times with the rejection, you can just edit directly here if you build the wrong amount or if you have the wrong MPI. You can save that here. But in the example where you, need to submit a new claim to the payer, we have created a new system where you can archive the original claim, meaning it will be saved for your records. We retain the entire history of the submission, and you will create a new claim that includes the date of service that you previously billed. And here, we can make changes directly on this claim form, and this will submit as a brand new claim to the payer. If you need to change the payer ID, you can do that in the client's record, and we recommend doing that before you generate the new claim, and then it will pull in your new information. And you can, easily reference back to your former claim. So if you need to go back and see how the original claim was submitted, you can switch back and forth by this arrow in the top left corner. And then, the other thing to call out is pay close attention to whether or not you need to submit your claim as a resubmission or not. The reason I call that out is because some payers want a new claim submitted as an original, meaning that you don't need to select any you don't need to put any, reference number here. And then other payers want it submitted as an official resubmission, where you would, include a reference number. For claims that have reference numbers, we will automatically pull that in when you create the corrected claim. So just pay close attention. Again, follow your payer's guidelines, and that will, determine how that claim should go out, and, that would be the most streamlined way to get those claims paid and corrected. Okay. So that is corrected claim workflow. And then the last thing I wanted to touch on is just our new claim rules feature. I just wanted to give, a quick look at how you can access your claim rules, what they look like, and how to change them. So claim rule automation is a feature that allows us to automatically update your claims based on conditions that we set here in your settings. Where this is useful is if you have payers that have different requirements around place of service, around modifiers, and especially if you're working with pre licensed clinicians and you're billing as a supervisor, You can add rules here that will apply to your claim when at the time that the claim is created. And so you can create a rule that says telehealth. We can select a payer and say, we can select a location. And common rule would be we need to change the place of service code so that anytime we bill from this location, we always want place of service code to be two, and we always want the modifier 95 to be applied. One thing to note, there's two different types of, telehealth modifiers. There's 95 and there's GT. Different payers have different requirements. We don't want you to be reliant on knowing that every single time you book an appointment, so it's helpful to learn the rule once, set it, and then forget it. It will automatically apply to every appointment moving forward, and if you accidentally select the wrong modifier from the appointment or maybe an admin staff does, then it will automatically change that. So that is everything on rules, and we can go to questions now. I'm gonna stop sharing. Well, I'll keep sharing my screen in case we need to go over anything. Great. Thank you, Maggie. Lots of good stuff here. Why don't we go to Maggie, before we touch on questions, I wanted to quickly invite Dylan up on stage. I know he had some best practices that he wanted to share, especially as we've launched a lot of these new features. So, Dylan, maybe you could take a couple minutes to just share some of your best practices. Yeah. Absolutely. Thanks for that walk through, Meg. That was really great. I just wanted to touch briefly on a few things about the new corrected claim flow that I think are important. So when you delete a claim and when to archive and correct. Now if the claim has never reached the payer, maybe you put it into prepared status or it's reached a scrub, you realize that that client was actually supposed to be self pay. Whatever the case may be, you're still gonna have that delete option. And for anyone missing the delete at all times thing, I'll extend a little olive branch that on the corrected claim button, you can hit the drop down arrow, edit that claim, and then save it because that will put it back into a prepared status and delete it. However, I do want to say that maybe we move away from our old ways and our old habits and start to move into this new corrective claim workflow and why that's so great. First of all, when our being able to archive the claims really protects your records in case of timely filing issues. I doubt I'm the only one here who has record of claims being submitted in a timely manner, but the payer is disagreeing with me. And if I had simply deleted those claims, then I go back into my civil practice account. I've lost my entire claim history. So the reason that our county is there is to protect those records. It's also great for when you're going back and forth with different edits and trying to figure out what's going wrong, you can reference what you have done before. So to that end, correcting a claim, the one thing to keep in mind is my my model with insurance is it depends. There's a very few hard and fast rules here. But to what Maggie was, discussing just a bit ago about the corrected claim versus an original claim is if you have a rejection, you can go ahead and submit that as original virtually every time. And then when it comes to denials, that claim is going to have been issued an original claim reference number or an ICN number. That's the number Maggie was saying is gonna pull in automatically when it's there. So if you're not seeing that get pulled in, then you probably are working on rejection. And if it is a denial, then for all payers, virtually all payers except for Medicare, you're going to want that original claim reference number. I think one of the greatest hits in the new workflow is the choose your own adventure of how you want to make a correction. Let's say that you have a new client. It came in for a 90791, and on the intake, we got a typo on the subscriber ID. Super common. Two ways to fix that now without having to edit every claim. One, you're maybe looking at that claim. You're seeing where the error is in the subscriber ID. You're gonna edit right there, create a new correct claim, update the subscriber ID. When you go to save that and submit, it's gonna pop up and ask you if you want to persist those changes to the account. So now you don't have to correct the claim and go back into the billing and insurance settings and correct the global settings as well. And then the other way of the choose your own adventure is to discover that you are missing the alpha prefix in a Blue Cross Blue Shield client subscriber ID, add it in in their billing and insurance settings. And then from there, you maybe you have multiple denials. You can just start opening those all up. I like to open them in a new tab, go one by one. When you go to create a corrective claim, it's gonna pull that information that you've now updated in the global settings, and you can just go one, two, three, bam, bam, bam, down the line. Correct your claim, see that it's updated the information, always give it a quick look around, make sure everything is in its right place, and then ship them all off that way. In the interest of time, those those would be my best practices for how to go about kind of navigating and getting used to and incorporating this new corrective claims workflow into your daily work. I love it. Thanks, Dylan. I love your gravest hits. I'm gonna quickly invite, Scott up to talk about our last update around payer representation and how we show the how we show our payers in the product. Sounds good. Thank you. I'm just going to share my screen really quickly. So I'll be very brief. As many of you probably noticed, we pushed out a change recently to how we represent our payers and our plans, throughout simple practice. So what we're seeing on screen right now is a couple of different workflows, where we see a lot of different plan names and a lot of, a lot of different entities that we're sort of treating as separate objects. But, really, if they're sharing a payer ID or there's multiple plans, that really roll up to a single payer, we could be doing a better job making it clear what you're interacting with as you go through your RCM cycle. And so as some of you have seen in the newer representation, we've consolidated these plans under actual payer entities. So you see on the left in the dropdown, you can see Blue Cross Blue Shield has multiple plans listed under it. On the right, we can see, again, multiple plans in the add payer workflow. The one extra thing I wanna call out, because I did see a question on it. This is a big back end change which had an accompanying set of front end changes. And we know that there are still things to work out, to make it as clear as possible what you're interacting with and make sure that you can differentiate between plans and payers, as you need to to make sure that you're billing correctly. So we'll be doing some outreach based on folks who've asked questions, to hear a little bit more about your experience with the new UI so that we can make sure everything is as clear as possible. As I said, a very quick update, but appreciate, you letting me take the time. Thanks, Scott. Lots of lots of content here. So I know we have a lot of questions. If I can invite, my friends back up on stage with me. Why don't we get into some of your questions with the time we have left? Great. Okay. From Rebecca Hanson. Thank you, Rebecca. On the client billing tab, can you please make the default date range the current year or at least ninety days instead of thirty days as a biller? I'd click to change this date range a 100 times a day. Maggie, do you wanna take this one? Yeah. I that's great feedback, Rebecca. I will, consider that with our team, but we don't have immediate plans to change the date range. We chose '30 as the default, for the month, but we can always consider the change. I would my recommendation to you would be to add it to user voice. And if we get enough upvotes, then we can definitely make that change. Thanks, Maggie. From Zach Bailey. Thank you, Zach. Is there a plan to clean up the look of the new insurance payer drop down list inside billing transaction insurance? Currently, the drop down has been changed in such a way that the entire payer name is no longer visible. Before, it showed the whole payer name. It makes it makes it a pain to differentiate between some payers that are nearly identical after this new change. Scott, do you have a do you have do you have a point of view on this one? Yeah. Absolutely. Zach, thanks for the feedback. As I said, we're definitely gonna reach out, with any sort of front end changes like this. Something that I always wanna prioritize is hearing how this actually impacts, practices and folks who are using them in these workflows. This is a really excellent piece of feedback that we wanna make sure that we're addressing. We have it, in our road map space to address UI issues like this, ideally, as fast as possible. So we'll definitely be reaching out soon. Thanks, Scott. And just a reminder for everybody. These questions are great. Sometimes we'll have immediate answers for them. Other times, there's great feedback for how we can make improvements. So keep it coming. We track this, and this is also a way for us to reach back out to you, to understand the why behind some of these requests. So, don't be surprised if we come knocking on your door as well to learn more. Alright. Karen. Thank you, Karen. Can we get the co pay coinsurance field to show in the sidebar as well as the client demographic billing insurance page again? The new update doesn't show it. I can take that one. Thanks, Karen. Let me take a look at that and talk to our team. Our intention was not to remove it, but let me let me double check to figure out why that happened. Jordan, is this something you've also observed, through some of the feedback and then questions you've gotten? I don't know if you have anything to add here. Yes. I was just gonna jump in. Our, product manager who maintains that area of the product, is aware this has been a request that's been coming up the last couple weeks. So, previously, any co pays you entered manually into the client settings, if you are on the essentials tier, that is not currently populating to that insurance tile on the right hand side of a client's profile. So our product manager's looking into that. She wants to make sure that, in addition to resurfacing it there, we're also surfacing those details, anywhere else that might be really helpful. So they're gonna look at it more holistically, and there should be an update in the coming weeks to return that to that tile. Thanks, Jordan. Thank you for the question, Karen. Alright. Laura, thank you for the question. Why does the insurance overview not list a co pay on a client's profile? I think it's the same question. She's question. so, yeah, we should be returning that in, the next handful of weeks. Yeah. Thanks, Laura. Alright, Scott. Thank you for the question. What when will sorting capabilities be added to client analytics income and billing reports? It is difficult to understand why basic column header sorting is not already available as this is a standard feature in most reporting tools and essential for effective data analysis. The absence of this functionality significantly limits usability and efficiency. This feature is critical need to prioritize balances highest to lowest. Currently, I must export data to Excel daily just to perform basic sorting, which is time consuming and inefficient. Totally understand, Scott. I think this is something we're aware of in terms of how we can improve the broader usability of our reports. I know we've talked to our reporting team about this, and I know this is on their radar. Scott and Maggie, I believe you're also in touch with them. Is there anything else in addition to add? I know we've had discussions about how to improve the general usability, but maybe you have more insight as to, like, when that might be coming. I was gonna echo what Shazad said that, in my conversations with the reporting folks, this is definitely on the roadmap to to have more sorting and and more filtering capabilities. So especially for larger practices, they have an easier time getting down to the data that is important to them at that moment, and not having, you know, reports time out and having issues getting to where they need to go. And I believe those are scheduled for the fourth quarter this year, but we can come back with, more specifics on their roadmaps when we talk to their product manager. And I will just add that our overall objective long term is to get everyone out of spreadsheets. So that's the kind of the push behind why we're why we're building what we're building and why we are trying to unify as much information as we can. We want you to be able to rely on the system to do everything that you need to do. Thanks both. I know we're at the, thirty minute mark here. So it's it's it's at our end of our scheduled time. We can stick around for another ten minutes or so to continue taking questions, but I just wanted to close out on on some housekeeping items, before many of our many of our coworkers need to need to drop. So as a reminder, we'll be sending out the recording of this live stream in a few days. This is part of our new series. So if you'd like to RSVP for the next edition of the billing brief, which will be on October 21, there's a link in the doc section. We have a fun show planned for the next one. We're doing some myth busting about verification of benefits and eligibility. So, tune in to to learn more about myths versus reality there. On Friday, this Friday, our CEO, Jonathan, will have his his monthly livestream, so called Let's Talk. So as always, he'll be addressing questions live. And last plug is, for those of us for those of you who are in our navigator, insurance navigator, trial, we'll be having another paid path to paid livestream hosted by, our our resident celebrity, Jordan, talk about what's new in the navigator navigator trial. So with that, I'm gonna go back to questions, for those who are still able to join us. Oh, Shazam, before we go to questions, I do want. to plug for the group that's still here, some updates that are coming. So one thing that we've heard a lot of feedback about that we are really excited to be working on advances for is secondary claims. So secondary claims, in the system right now is a very manual process and something that we are planning to release likely at the beginning of next year is going to allow you to track your secondary claims, so that you have more visibility into which clients have secondary coverage and which when your primary claims are ready to second ready for secondaries that you can batch file those. So that is one I know everyone who stayed on for will be really excited, and more to come. We'll likely go over that in a brief once that feature is ready to be demoed. That's exciting. I know I've heard about that one many times. So thank you, Maggie. Alright. Thanks, Tamara, for your question. When adding a note to a claim, can a note symbol be added under the billing tab for that particular data service? Maggie? I wanted to share because I I wanna make sure we're talking about the same thing. So if I maybe it's not letting me share my screen right now. Oh, it's probably because the question is up. Let me walk through. So when you add a note right now to the to the claim so, we we were on the claim form. We went to claim notes. We added this note. When I go back to the claim list, there is a symbol here. So, this is the only place where you show it right now. But, if it would be helpful to see it in the client's overview or anywhere else that you can think of, please write in and let us know. But this is where you can see it right now, which I do think is helpful, you know, when you're viewing overall. But yeah. Sorry. I'm just going on. That's hopefully, helps you helps answer your question. Thanks, Maggie. Mhmm. I think there's some comments in the chat about, about that topic, so feel free to quickly peruse that as people are responding to your answer. Okay. Alright. Next question. Hi, Scott. Thank you. Hi. There appears to be a mismatch between client balances and analytics reporting. For example, the $60 balance was written off after collecting a 190 of a 310 session fee. While the client profile correctly shows a $0 balance, the analytics report still lists the full 310 as outstanding. Can you explain why written off balances are not reflected in analytics reports and whether this behavior will be corrected? Jordan, do you have a point of view on this one? So bounce right off. Yeah. We would have to specifically look at the account to see the discrepancy, and then that usually can, inform us why there is a difference. K. So I would say, Scott, if you're looking to clean up your books, definitely write into us through the question mark icon at the bottom right of your account, and we'll take a look. If you have specific client examples, attached to their URL, we'll kinda expedite that process. I'm also wondering if if part of this discrepancy might be that the entire $310 isn't perfectly balanced, so it's still showing as open. But again, we'll need to take a a closer look at the specifics. Yeah. Thanks, both. Liz, thank you for your question. Why does a client still show up as having a particular insurance if their insurance effective end date has passed? We have clients who we like to keep the old card on file and have entered it when it became inactive. However, when I'm pulling a report, the client is still showing up as having the old insurance. I wanna see clients who have that insurance now. I don't care if it is expired. That makes sense. I'm not exactly sure what it looks like in what report we're talking about here, but I would just note that once it's once it's no longer active, it is best practice to keep that card on file. But just be sure you're setting it to other rather than keeping it listed as the primary chart because then it's gonna pull into the report for sure that way as still the active insurance on file. Because in our system, the date range is there for your reference and for your own tracking, but it it's it's not, directly relating and and telling our systems that that insurance is no longer active. So I would just Thanks, Dylan. William, when we make a manual insurance payment, can there be a way to add a comment to clarify why we did it? That's a good question, William. Right now, I would recommend using the claim note because most likely it's related to it's gonna be it's gonna be related back to the claim. We do have a way for you to reconcile when a payment was added manually. However, there isn't a specific note on the payment. That note would be available on the claim form. Thanks, Maggie. Alright. I think we have time for a couple more. Stacia, hopefully I pronounced that right. Thank you for your question. Can we get a tertiary insurance added? One step at a time, Sasha. Let us get secondaries in a better place, and then I think, from there, we will explore, tertiary. Thanks, Maggie. Alright. Candy, thank you for your question. How do we unarchive claims? Sure. So a claim can be unarchived if the corrected claim has not been submitted to the payer. So if the claim is in a prepared or edited state, prepared, edited, or scrubbed state, you can delete that new claim that you created, and it will unarchive the original claim. However, once a new claim has been submitted to the payer, you do not have a way to go back and unarchive that claim. Thanks, folks. I I know there's a lot more questions. So what we'll do is we'll take those questions. We'll try to get back to you. And, again, this kind of informs our future sessions. So, once again, on on behalf of the team, thank you so much for your time. We've really enjoyed this and, always enjoyed connecting with you guys, and, we will, see you we will see you at the billing brief next month talking about eligibility. Have a great rest of your week. One Thank you.