This five-video training series provides a practical guide to claims, billing, insurance, and private payment in clinical practice. The series covers the ethics and language of insurance, payer-specific requirements, coding and modifiers, current Simple Practice claims workflows, and private-pay practices—including superbills, Good Faith Estimates, sliding scales, and payment processing.
Part 1: Insurance, Ethics & Patient Care
An introduction to the ethical, clinical, and practical considerations involved in accepting insurance. Covers patient education, third-party payment, insurance terminology, primary and secondary coverage, in-network and out-of-network care, and other important concepts counselors need to understand when working with insurance.
Part 1.5: Coding & Modifiers
A focused review of the coding basics needed for accurate billing and claims submission, including commonly used CPT codes, Place of Service codes, and modifiers. This supplemental video overlaps with content from Part 10 of Documentation Boot Camp and is included here for anyone who has not yet completed that training.
Part 2: Insurance Payers & Their Rules
A payer-by-payer look at the insurance plans commonly used at OpenGate, including Vermont Medicaid, Blue Cross Blue Shield of Vermont, Cigna, MVP, CBA Blue, and others. Covers who can bill each payer, payer-specific requirements, claim setup, coding considerations, and the important differences clinicians need to know.
Part 3: Claims & Billing Workflows in Simple Practice
A step-by-step guide to setting up clients for accurate billing and managing the claims process in Simple Practice. Covers client insurance and billing setup, creating and submitting claims, correcting claims, and managing payments. This training reflects Simple Practice’s most current claims and billing workflows as of September 2026.
Part 4: Private Payment & Billing
A practical overview of billing outside of direct insurance claims. Covers private-pay clients, superbills, Good Faith Estimates, sliding-scale arrangements, credit card processing, and other financial and administrative considerations involved in collecting payment for counseling services.