Setting Up Your Insurance Billing Profile

In this article:

• Accessing Your Insurance Billing Settings
• Configuring Your Company Profile
• Adding Insurance Payers
• Setting up Your Individual Profile
• Configuring Superbill Delivery
• Setting Place of Service Defaults
• Defining Your Default Service Facility
• Managing Claims Processing
• Saving Frequently Used Codes

Accessing Your Insurance Billing Settings

Getting to your insurance billing configuration is straightforward, and you'll find everything you need in one centralized location.

1. Click the Settings button (gear icon) and select All Settings & Preferences.
   
    
2. Choose Insurance Billing from the available options.
   
    
3. Team plan users: Use the Team Member Switcher in the bottom-left corner if you need to select a different team member and set up their profile on their behalf.
   
    
4. Read below to understand the available options and settings on this page. 
    
5. Be sure to Save Changes near the top-right after updating your Insurance Billing Settings.
   

Configuring Your Company Profile

Your company profile contains the foundational information that appears on all your insurance documents.

Default Tax ID

Enter either your Social Security Number (SSN) if you are a solo practitioner or your Business EIN if you are part of an organization.

📍 Note: Your Tax ID is encrypted and not stored in plain text. The unmasked Tax ID will only appear on superbills and CMS-1500 PDF forms. You may still create insurance claim forms in Practice Better without an NPI number, but they won't be accepted for submission by a payer without it.

Organization NPI (Type 2)

Optionally, add your organization's NPI number if applicable.

Organization Taxonomy Code

Enter your organization's taxonomy code in this field. When creating a new CMS-1500 form, Box 33b (Billing Provider Other ID) automatically prefills with the organization taxonomy from your settings. You can review and override the prefilled value if needed before submission.

⚠️ Important: Most payers require that the taxonomy code always corresponds to the NPI being used. Setting your organization taxonomy code here ensures compliance and reduces errors during claims submission.

Billing Address

If you have saved one or more Locations, select your preferred default from the picklist. If you see clients at multiple locations, you can set up additional locations in your Company Profile settings.

Adding Insurance Payers

Save commonly used insurance payers' information here. These will be selectable in Superbills and Claims created in Practice Better, making it easy to generate documentation without re-entering payer details each time.

Managing Saved Payers

Click the Edit button to update a saved payer's information, or click the Trash icon to delete a payer. After either action, click Save Changes near the top-right.

Required Information

At minimum, you'll need the payer's Name and Payer ID. You can also save optional details like phone number, fax number, and mailing address.

💡 Find the Payer ID of many common insurance payers in the list here:  Claim.MD Payer List. 

Setting up Your Individual Profile

NPI Number and Taxonomy Code

Enter your individual NPI number and taxonomy code in the My Profile section.

💡 Tip: If you do not know your taxonomy code, search for it at: https://npiregistry.cms.hhs.gov/. 

Enabling ICD-9 Codes

By default, the system uses ICD-10 codes. If you still submit claims with legacy ICD-9 codes, enable the "Use ICD-9 diagnosis codes?" option.

Configuring Superbill Delivery

• Default Setting: Superbills are sent as secure download links through the Client Portal.
• Alternative Option: You may choose to send superbills as email attachments.

⚠️ Important: Avoid sending sensitive information, such as SSNs, in email attachments for security reasons.

Setting Place of Service Defaults

These settings determine where services are documented as being provided for insurance purposes, and they can automatically populate based on your appointment type.

Accept Assignment by Default

Participating providers must abide by the terms of their contract with an insurance plan or program. When you accept assignment, you agree to accept the insurance payer's approved payment amount as full payment for covered services, and the payment comes directly to you rather than to the patient.

📍 Note: If you are a participating provider with any insurance plan, you must follow the assignment requirements outlined in your contract.

Phone and Telehealth Sessions

Set default service locations for phone and telehealth sessions within the Insurance Billing settings. These defaults will automatically populate in claims based on your appointment type.

In-Person Sessions

Set the Place of Service code in My Schedule > My Locations for in-person appointments. Learn more about Setting up Office Locations for Insurance Billing.

Defining Your Default Service Facility

If your default claims location is different from your Default location in My Schedule > My Locations, enter it here.

📍 Team Plan Note: This setting can be customized for each team member, allowing flexibility for practices with multiple providers working from different locations. As a team admin, your ability to view and configure other team members' insurance billing settings depends on your assigned permissions level. Team members won't receive notifications when you set up their insurance billing profile, and they can override these settings if they have the appropriate permissions.

Managing Claims Processing

Denied Claims Balance Behavior

Click the checkbox to enable the option: "For denied claims, default client responsibility to full claim balance unless ERA patient responsibility is available." This ensures accurate client billing when claims are denied.

📍 Note: Updating your insurance billing settings won't apply changes retroactively to already created claims or superbills.

Saving Frequently Used Codes

Practice Better provides access to a database of ICD-10 codes that can be searched when editing a Claim or Superbill. To make your workflow even more efficient, you can save your most commonly used codes.

Adding Custom Codes

1. Use the Fast Action Button (bottom-right corner) to select:
   
   • Add ICD-10/9 Diagnosis Code
   • Add Procedure Code
2. Enter a frequently used code and details (codes can be saved one at a time).
    
3. Click Save Changes near the top-right of the settings page. 
    

Sharing Codes with Your Team

These codes can be Shared with team members for easy population in Superbills and Claims. Shared codes are visible to all practitioner team members in the same account and populate in drop-down menus when creating insurance claims, superbills, and configuring insurance settings in Services.

Managing Saved Codes

On the Insurance Billing Settings page, click the Edit button to update a code. Or click the More Options Menu (3 dots) next to a code to delete it or manage sharing. After either action, click Save Changes near the top-right.

✅ All set: Once you've configured these settings, your insurance billing profile is ready to go. Before generating superbills or submitting claims, consider also configuring insurance settings in your Company Profile and Services sections for a complete setup. Practice Better's support team is here if you need assistance along the way.