🎉Benefits Verification🎉

Benefits verification is a process that verifies a patient's health insurance coverage and benefits prior to the start of services to ensure that the insurance company will pay for the services provided. This process is important for you to receive proper reimbursement, prevent patients from having unexpected medical bills, and minimize the amount of claim denials. It also gives us the opportunity to advise patients of their estimated cost per session, set the billing defaults in advance so they are billed correctly from the beginning, and add any required modifiers to their service codes.

Unlike other billing companies, this service is provided at no additional charge for clients of Simplify Therapy Billing & Practice Management.

To facilitate this process, we have created a secure HIPAA-compliant form for your practice to use. You can either enter patient information individually or, if you have multiple patients to verify, upload an excel/csv file with the relevant information. A visual representation of this process can be found on this page.

Please note: Any email requests for benefits verification will be redirected to this form.

To Get Started:

  1. Add prospective/new clients to your EHR

  2. Ensure you have the information needed (name, date of birth, member ID)

  3. Submit the form here (or click the button at the bottom of this page)

  4. Our team will reach out if the insurance policy is invalid, out-of-network, or requires a pre-authorization

    • If pre-authorization is needed, our team will start the process and let you know if clinical information or provider signature is needed

  5. Once finalized, notes will be added to the chart (Admin Note for SP, Patient Comment for TN) and the patient’s default copay will be updated

Benefits are verified in order of priority based on the intake date included on the form or spreadsheet.

Ready?

First, a reminder that a quote or verification of benefits and/or authorization does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member's contract at time of service.

Set?

Secondly, here is a link to the excel and csv templates for bulk patient submission.

Go.