Billing under a group NPI vs. an individual NPI: Which is right for you?
Most claim problems start before the claim goes out, making proactive steps to reduce billing errors essential for your bottom line. The best way to reduce billing errors private practice owners face is to fix the setup, not submit faster. Here's where billing time goes and what causes rejections.
How long does billing take?
Personally, from my experience, using a system like SimplePractice makes insurance billing easy and seamless, as long as the information you enter in the system is correct and you are credentialed correctly. Technically, when everything is set up correctly, it should not take too long per claim. The time comes when the payments come in: checking that you are paid timely and correctly based on your contract, that copayments are paid, reviewing your billing monthly, and doing your own audits.
Data on how much time billing takes therapists is limited. A 2015 American Psychological Association survey found that psychologists spent about 7.4 hours a week on administrative and management tasks, and that covers all admin, not just billing.
Following up with payers is a big part of that. In the 2023 CAQH Index, medical providers reported spending about 25 minutes on each manual claim status inquiry. Every step you take to reduce billing errors private practice staff would otherwise chase cuts into that time.
Why do my insurance claims keep getting errors?
Because every time information is typed twice, it can be typed two different ways. A client's name is spelled one way in your EHR and another way in your billing software. A member ID is missing a digit.
The payer checks your claim against its own records, and if anything doesn't match, the claim comes back. Entering information once is the most direct way to reduce billing errors private practice owners create without realizing it.
In Experian Health's 2025 State of Claims survey, half of providers named missing or inaccurate claim data as a top reason for denials, and 32% pointed to incomplete or incorrect patient registration data.
What causes clearinghouse rejections in mental health billing?
Common clearinghouse rejections in mental health billing include:
Client name, date of birth, or member ID doesn't match the payer's records
Wrong payer ID, especially for Medicare Advantage and Medicaid managed care plans
Rendering and billing NPI mixed up, or the wrong taxonomy code
Wrong place of service or modifier for telehealth
Missing or invalid diagnosis code
To effectively reduce billing errors, it helps to know the difference between a rejection and a denial. A rejection happens before the payer processes the claim, usually at the clearinghouse. A denial means the payer processed the claim and decided not to pay it. Catching clearinghouse rejections in mental health billing early is one of the easiest ways to reduce billing errors private practice teams overlook.
Which is better: EHR billing vs. separate software?
From my experience, it's best to have one system where everything talks to each other. Working from a system that's two in one is helpful because the systems talk to each other. When you weigh EHR billing vs. separate software, a connected system is the most reliable way to reduce billing errors private practice owners face from double entry.
Separate billing software can make sense if you have a dedicated billing team or work with an outside biller who uses their own system, but you must establish strict communication protocols to reduce billing errors. If you go that route, always make sure the information loaded in both systems is consistent, correct, and matches your contract and credentialing.
How long to fix denied claims?
It depends on the payer. Each insurance is different with their timelines. It's important to have an SOP for each payer based on their provider manual along with your contract. Your appeal deadline is in each payer's provider manual or your contract. Put it in your SOP so nobody has to look it up after a denial comes in.
For Medicare, claims must be filed within 12 months from the date of service, and a redetermination request must be filed within 120 days of receiving the initial determination notice. Claims denied for timely filing aren't eligible for a redetermination, the first level of appeal. Medicaid deadlines vary by state, so check your state's Medicaid provider manual.
Once the claim goes out, it depends on how it goes: electronically or by mail. Many practices stay away from mail since it takes longer. From my understanding, you have to wait until the claim has been received and processed or denied by the payer, which causes a delay.
Electronic claims get an acknowledgment from the clearinghouse and payer within a day or two, so you know right away if a claim was accepted or rejected. With paper, you often don't find out anything until the payment or denial shows up weeks later. Going electronic helps reduce billing errors private practice owners otherwise catch too late.
One more thing: a rejected claim was never accepted by the payer, so it doesn't count as filed. A claim rejected in week one and found in month four may already be past the deadline. Review rejections weekly to reduce billing errors private practice owners can still fix in time.
How can a group practice cut down admin time across billing and payroll?
For me, it's about making sure your foundation is strong.
Do you have SOPs for each payer?
Is everyone credentialing and re-credentialing correctly?
Do you have your fee schedule?
Do you know how to bill efficiently to reduce billing errors?
Do you have an SOP for billing?
Having your demographics, billing codes, and modifiers correct matters. A strong foundation is how you reduce billing errors private practice groups multiply across every clinician.
Once the foundation is in place:
Use one intake process: Collect the front and back of the insurance card, verify eligibility before the first session, and enter it once.
Close notes on time: Set a deadline for signing notes so claims don't sit.
Run payroll from the same data: Pull payroll from the appointments and payments already in your system instead of a separate spreadsheet. SimplePractice, for example, has an income allocation report that pulls payments and appointment counts together for payroll.
Give one person ownership of follow-up: Someone should review payments, rejections, and denials every week.
What's the bottom line?
A disconnected workflow costs you a little at a time: a mistyped member ID, a missed rejection, a payment nobody checked. To reduce billing errors private practice owners spend hours fixing, use one connected system, keep an SOP for every payer, and review your billing every week.
Sources
American Psychological Association (2015). 2015 APA survey of psychology health service providers.
CAQH. (2023). 2023 CAQH index report.
Centers for Medicare & Medicaid Services. (n.d.). Medicare claims processing manual: Chapter 1, general billing requirements.
Centers for Medicare & Medicaid Services. (n.d.). Medicare redetermination request form (CMS-20027).
Experian Health. (2025). The state of claims: 2025.
How SimplePractice streamlines running your practice
SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.
If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.
Try SimplePractice free for 30 days. No credit card required.
