How Billers Work in SimplePractice

An outside biller can work inside SimplePractice to prepare claims, investigate billing problems, and keep insurance payment records current. You keep using the EHR for your practice and supply the clinical documentation. The biller’s work is following each visit from “ready to bill” through the payer’s response and an accurate balance—not just clicking Submit.

The key distinction: a claim being created, a payer processing it, and money reaching your practice are three different events. Agree on which parts your billing service will handle and how it will report unfinished work.

For US therapy practices • Vendor documentation checked October 19, 2026. Account settings and features can change.

What access does a SimplePractice biller need?

The Practice Biller role covers claims, billing documents, payments, and reports, and includes access to client diagnoses. Adding team members requires the Plus plan. Review optional permissions carefully: access to client documents can expose progress notes and psychotherapy notes. The role name alone does not tell you everything someone can see. SimplePractice’s administrative-role guide explains the boundaries.

Give the biller their own team account rather than your login. Agree separately on authority for patient charges, refunds, and adjustments; a software permission is not a blanket instruction to use it. For setup, see how to add a biller in SimplePractice.

Before filing: resolve missing or conflicting information

A useful preclaim review compares the client’s payer and member information, the clinician’s billing identifiers, and the service details with the practice’s records. SimplePractice identifies incorrect demographics, insurance information, diagnosis codes, and provider information among common claim-rejection problems.

This is where the human work begins. If a diagnosis is missing, the biller asks the therapist to supply it. If the recorded service seems inconsistent, the biller asks what was actually provided. Neither problem should be solved by guessing.

Some payers require an accepted claim-filing enrollment before electronic submission. Payment Report enrollment is a separate connection for electronic remittance information. Neither is the same as becoming contracted with a payer. SimplePractice’s insurance setup guide describes the enrollment steps.

At the initial handoff, identify which service dates were already billed elsewhere. Visits billed through an outside platform need a different recording workflow; see recording Headway or Alma payments in SimplePractice.

The biller follows both appointments and created claims

In Billing → Claims → Appointments to file, the biller reviews insurance appointments without a created claim. But creating a claim can leave it Prepared, waiting to be sent. Created claims appear in Claims filed. A visit disappearing from the first list therefore does not prove successful submission. Billing hub guide.

After submission, Accepted or Received still does not mean paid. Without Payment Reports, the EHR may not show the payer’s final decision until someone records the outcome. The biller needs to check the response, not assume an unchanged label means the payer has done nothing. Understanding claim statuses.

Rejections and denials need different investigation: a rejection occurs before payer processing, while a denial follows processing. Read the actual reason before choosing a correction or response. SimplePractice’s rejection guide.

A dashboard trap: Action required identifies scrubbed claims. Rejected or denied claims may also need follow-up without carrying that label. The biller should review those statuses separately, as the Billing hub documentation explains.

Payment posting is not the same as receiving money

When Payment Reports arrive, SimplePractice automates insurance-payment bookkeeping and updates recorded client responsibility. The payer’s money travels outside SimplePractice. An updated client balance also does not mean the client has paid it. Insurance billing and income documentation.

When manual entry is necessary, the biller uses the payer’s explanation of benefits (EOB) to allocate the payment to the correct visits. Check for an existing payment first: an EOB and an electronic report may describe the same transaction. SimplePractice also supports tracking whether a recorded payment was actually received. Adding insurance payments.

Fictional example: three Received claims that were already paid

Maya sees three claims marked Received and assumes insurance still owes her. The payer sent a paper EOB and a check, but no electronic Payment Report reached the account. The owner confirms receipt, and the biller matches the EOB to the visits, checks for earlier entries, and records the payment once. The next step was completing the records—not sending three new claims.

What should the therapist still provide?

Keep diagnoses, service details, and clinical documentation accurate, and agree on how to signal that a visit is ready for billing. Share insurance changes and payer correspondence promptly. A biller can flag a documentation question and track a request; the therapist supplies the clinical explanation.

For a short billing check-in, ask:

• Which visits have no claim, and which created claims are still unsent?

• Which unresolved claims need action, who owns the next step, and when is the next check?

• Which recorded insurance payments have not been matched to actual receipts?

These questions connect the work list, payer responses, and cash received without making you inspect every claim yourself.

Shameless Bomi plug

Bomi works as a billing user inside SimplePractice, so you can keep your EHR while getting human billing help. If the software is working for you but the follow-up is eating your evenings, talk with us about billing support.

Sources

• SimplePractice: Administrative roles

• SimplePractice: Getting started with insurance billing

• SimplePractice: Managing the Billing hub

• SimplePractice: Understanding claim statuses

• SimplePractice: Resolving claim rejections

• SimplePractice: Adding insurance payments