Understanding Your Month-End Reports
Help Therapy is committed to timely billing and efficient claims processing. Each month, you will receive an invoice reflecting received payments, paired with detailed reports of all claims paid and recorded by our team during that period.
⚠️ Action Required: EFT Enrollment vs. Paper Checks
We are nearing 100% electronic integration. If you are still receiving paper checks, please contact our Provider Relations team at provider@helptherapy.com to sign up for EFT.
Why it matters: Paper checks create significant reconciliation delays.
Payment Lag: We occasionally post payments to your account before physical checks arrive. Switching to EFT is the best way to ensure your reports and bank deposits remain perfectly in sync.
1. SimplePractice Reports (Primary)
Since most of our billing has transitioned to SimplePractice, these are the primary reports you will use:
Income Allocation Report: Lists all insurance and patient payments recorded during the month. Use this to confirm paid sessions and reconcile them against your monthly invoice.
Unlocked Appointments Report (SimplePractice EHR Users Only): This is your safety net. It lists appointments where the progress note has not yet been finalized.
Action: Because appointments must be locked to be billed, please review this list regularly. If you see a completed session, simply lock the note so we can submit the claim for you.
2. Account Activity Report (Legacy)
Some providers may still receive this report for aging claims currently sitting in Tebra. This report will be phased out once all remaining legacy claims are settled.
DOS & Code: The Date of Service and the CPT code billed for the encounter.
Total Charges: We bill a templated charge to insurance. Please note: Insurance companies do not pay this full amount.
Total Payments: The actual amount paid out by the insurance company, typically based on your specific contract and licensure.
Adjustment: The difference between the amount billed and your contracted reimbursement rate (see "Understanding Insurance Adjustments" below).
Total Balance: Outstanding amounts not yet paid by insurance; this may include patient co-pays.
Understanding Insurance Adjustments
As an independent practitioner, you are contracted with various insurance carriers, each with its own fee schedule (often based on Medicare rates).
We intentionally bill an amount higher than the expected reimbursement to ensure we capture the maximum allowed amount. The "Adjustment" on your report is simply the clerical difference between that high-end billed amount and your specific contracted rate.
- A Note on Co-pays and Balances: If a patient owes a co-pay, it may appear in the “Balance” column even after the insurance portion is settled. We recommend collecting co-pays at the time of service.
- Tip: Co-pays are often higher at the start of the year due to deductibles. Upon request, we can hold Medicare billings at the beginning of the year until these co-pays are settled.
Timelines & EOBs
Insurance processing typically takes 2–6 weeks. Consequently, your current month-end report may include payments for services provided in previous months.
Streamline Your Workflow: As an independent practitioner, paper EOBs (Explanation of Benefits) are typically mailed directly to you. While our team proactively tracks and calls for payment info, having the EOB is an essential fail-safe for reconciling "hard-to-find" payments.
Note: With some carriers, once we have ERA (Electronic Remittance Advice) fully set up, you may stop receiving paper EOBs entirely. To ensure we have everything we need, we recommend two options:
Manual: Forward any EOBs you receive to billing@helptherapy.com.
Automated (Recommended): You can set up your EOBs to be sent directly to our billing team, eliminating the need for manual forwarding. If you are interested in this "hands-off" option, please reach out to us so we can help you get this configured.