Insurance billing lets you enroll with insurance payers, submit claims for your sessions, and track payments, all inside Upheal.
Insurance billing is only available in the US.
Who can access insurance billing?
Insurance billing is available on certain paid plans.
If you are a solo provider (the admin of your solo practice) on certain paid plans, you have full access to insurance billing.
For group practices, admins and practitioners have different permissions. To learn more, see Insurance billing with group practices.
How much does it cost?
Charges for insurance billing are usage-based: $0.30 per claim submission and $0.15 per eligibility check. There's no setup cost, no extra charge for ERAs or ERA downloads, and no monthly fee beyond your usual per-session pricing.
FAQ
Do I keep my own payer contracts?
Yes. You bill under your own NPI, with your own payer contracts and rates. Upheal gives you the tools to submit claims, check eligibility, and track everything in one place. Your payer relationships stay yours.
Do I need a separate clearinghouse?
No. Clearinghouse connectivity is built into Upheal, the same way a payment processor handles card networks for you behind the scenes. Enroll a payer for electronic claims, eligibility checks, and ERAs, and everything runs through one loop. If you'd rather keep your current clearinghouse for now, you can. Just post payments manually from your EOBs or ERAs.
Do I have to learn billing to use it?
No. Claims fill themselves in from your notes and client details, problems are flagged before you submit, and payments match themselves when the ERA arrives. If a payer rejects something, you'll see why in plain terms. And when you're not sure about anything, ask the Assistant, or get in touch with Support.
What does it cost?
Insurance billing is usage-based: $0.30 per claim submission and $0.15 per eligibility check. There's no setup cost, no extra charge for ERAs or ERA downloads, and no monthly fee beyond your usual per-session pricing.
What payers can I connect to?
You can see a complete list of payers you can connect to here. Note that Upheal only supports claim submissions, eligibility checks, and ERAs.
Can I bill for clients with secondary insurance?
Yes. Each client's profile holds their primary and secondary insurance, and you can bill secondary claims through Upheal, so clients with two plans don't mean two workflows. Tertiary insurance is also supported.
What happens if a claim is denied?
You'll see the denial next to the session it belongs to, along with the reason, and Upheal will draft an appeal for you, pulling relevant information from the client's chart to establish medical necessity. You review, edit if needed, and send. You can also edit the claim.
Is supervisory billing available?
Supervisory billing functionality will be available soon.
Is organizational billing supported?
Organizational billing functionality will be available soon.
Learn more
For a more in-depth look at insurance billing with Upheal, read more: