SimplePractice Insurance Billing Cost 2026:
$0.25 Per Claim + What You Can Avoid
Insurance billing is one of SimplePractice's most valuable features, but it comes with per-claim fees that add up. Here is exactly what you pay, how it compares to using a free external clearinghouse, and how to minimize your total billing costs.
Per claim fee
$0.25
Electronic claims via built-in clearinghouse
Available on plans
Essential + Plus
Starter does NOT include insurance billing
Free alternative
Office Ally
External clearinghouse with no per-claim cost
Monthly Clearinghouse Cost by Claims Volume
| Insurance claims/month | Clearinghouse fees | Total Essential cost (plan + clearing) |
|---|---|---|
| 10 claims | $2.50 | $81.50/mo |
| 25 claims | $6.25 | $85.25/mo |
| 50 claims | $12.50 | $91.50/mo |
| 100 claims | $25.00 | $104.00/mo |
| 150 claims | $37.50 | $116.50/mo |
| 200 claims | $50.00 | $129.00/mo |
Based on Essential plan at $79/mo + $0.25/claim. Does not include credit card processing fees.
ERA Posting: What It Is and Why It Matters
ERA (Electronic Remittance Advice) is the response from insurance payers after processing a claim.
Through SimplePractice's built-in clearinghouse, ERA responses are automatically received and payments are posted to client accounts. This eliminates manual reconciliation of insurance payments, which can take 1-3 hours per week for a busy insurance-heavy practice.
If you use Office Ally (the free alternative), ERA posting still works but requires more manual steps. For high-volume insurance practices, the $0.25/claim fee at SimplePractice may be worth paying for the automated reconciliation.
SimplePractice Clearinghouse vs Office Ally: Decision Guide
| Factor | SimplePractice Built-In | Office Ally (Free) |
|---|---|---|
| Per-claim cost | $0.25/claim | Free |
| Setup complexity | None (built in) | Requires enrollment + configuration |
| ERA auto-posting | Automatic | Manual or semi-manual |
| Claims status tracking | In SimplePractice dashboard | Separate Office Ally portal |
| Support | SimplePractice support | Office Ally support |
| Best for | High efficiency, high volume | Cost-sensitive, fewer claims |
Rule of thumb: if you submit fewer than 40 claims per month, Office Ally saves $10/month or less. The time saved by automated ERA posting may be worth more. Above 100 claims/month, Office Ally saves $25+/month, which justifies the setup friction.
Credit Card Processing Fees
Beyond clearinghouse fees, SimplePractice charges for payment processing:
Credit/Debit Card
2.95% + $0.30
Powered by Stripe. On a $150 session: ~$4.73 fee.
ACH Bank Transfer
1% ($1 min)
On a $150 session: $1.50 fee. Encourage ACH to save ~$3/session.
Frequently Asked Questions
How much does SimplePractice charge for insurance billing?
$0.25 per electronic claim submitted through the built-in clearinghouse. Available only on Essential ($79/mo) and Plus ($99/mo). Starter does not include insurance billing.
Can I use Office Ally instead?
Yes. Office Ally is a free external clearinghouse. It requires separate enrollment and configuration but eliminates the $0.25/claim fee. ERA posting is less automated than the built-in clearinghouse. Best for cost-conscious practices submitting 40-100+ claims per month.
What is ERA in SimplePractice?
ERA (Electronic Remittance Advice) is the insurance payer response after processing a claim, showing what was paid, adjusted, or denied. SimplePractice auto-receives and posts ERAs from its built-in clearinghouse, saving significant manual reconciliation time for insurance-heavy practices.
What is the credit card processing fee?
2.95% + $0.30 per transaction for credit/debit cards (Stripe). ACH bank transfers cost 1% with a $1 minimum. For a $150 session: card costs ~$4.73, ACH costs $1.50. Encouraging clients to pay by ACH saves approximately $3/session.