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Updates
Assignment of benefits and patient amount paid now flow through to payers
Insurance claims submitted from Thrizer now carry two pieces of the claim through to the payer that previously did not reliably make it onto the submitted claim:- Box 27 — Accept assignment. The claim’s assignment-of-benefits decision is now stamped on both the electronic 837 submission and the manual ClaimMD CSV. When the client’s plan assigns benefits to the provider (typical for pay-in-full claims where Thrizer is reimbursed directly), the claim is marked Yes. When benefits are assigned to the client (typical for instant reimbursement claims where the client already paid the full session fee up front), the claim is marked No.
- Box 29 — Amount paid. If the client has already paid any portion of the session fee at the time of submission, that amount now appears on the claim. Box 28 (the billed fee) is unchanged.
- Pay-in-full and instant-reimbursement claims are now routed to the correct party (provider vs. client) at the payer, matching the plan’s assignment of benefits.
- The client’s already-paid amount is visible to the payer, so the explanation of benefits reflects what the client owes after the visit, not the full billed fee.