Claim and billing limitations

​

Overview

Thrizer supports common out-of-network payment and claim processes, but some billing setups cannot be handled automatically. In general, Thrizer is structured around a few core rules:

• One charge connects to one claim
• One charge supports one CPT code
• A claim can only be submitted when the required information is complete
• A claim is submitted only after the client payment is successfully processed

If a request does not fit that structure, it may need to be handled differently.

​

How this works

This article explains common claim and billing limitations so you know what to expect before creating a charge, submitting a claim, or choosing a payment option.

​

Can one session be split across multiple cards?

No. A single session charge cannot be split across multiple payment methods. The client needs to use one payment method for the full charge.

​

Can multiple charges be combined into one claim?

No. Thrizer does not automatically combine multiple charges into one insurance claim. Each charge corresponds to a single claim. If a session is split into multiple charges, those charges remain separate for claim purposes. This matters because insurance carriers review claims based on the information submitted on each claim. A split payment or split charge may not behave the same way as one combined session claim.

​

Can one charge include multiple CPT codes?

Each charge supports one primary CPT code. Thrizer does not currently support multiple units of the same CPT code, such as 97110 × 3. A different time-based add-on code may be included only when Thrizer has explicitly documented the exact primary/add-on combination as supported. The currently documented supported combination is 96132 with 96133, with each code included once. If your combination is not documented, contact Thrizer support before charging; do not assume that an externally recognized add-on relationship or a past successful claim means Thrizer supports it. If a session includes unrelated services that require separate CPT codes, those services need to be billed as separate charges. Each charge creates its own claim. A CPT code is the billing code that identifies the type of service provided. Insurance carriers use CPT codes when reviewing claims.

​

Can a claim be submitted without a diagnosis code?

No. A diagnosis code is required before submitting a charge that generates a claim. Add Charge enforces this in the form. When the selected client has no qualifying diagnosis on file:

• OON Pay and Thrizer Pay are disabled in the billing type dropdown.
• If one of those options was already selected, the form silently switches the charge to Self-Pay and shows a warning toast.
• The form prevents an insurance charge from being submitted without a diagnosis, so no payment is collected and no claim is created.

Self-Pay does not require a diagnosis and remains available. To unblock insurance billing, add a diagnosis on the client detail page (Edit Diagnoses) and then return to Add Charge. A diagnosis code is part of the insurance claim record. It helps identify why the service was provided.

​

Can a failed payment still trigger a claim?

No. A claim is submitted only after the client’s payment is successfully processed. If the client’s payment method fails, the charge does not go through and Thrizer does not submit the claim. Resolve the payment issue with the client and retry the charge. Thrizer does not submit claims without successful payment, and failed charges are not automatically retried.

​

Can a completed charge be moved to a different card?

No. Completed charges cannot be reassigned to a different payment method. If a client adds a new card, that card can be used for future charges. It does not change the payment method used for past charges.

​

Can past sessions be changed to Thrizer Pay?

No. Thrizer Pay can only be applied to future sessions. You need to select the payment type before submitting the charge. Past sessions cannot be converted to Thrizer Pay after the fact.

​

Is there a maximum charge amount in the Clinician Portal?

Yes. Charges submitted from the Clinician Portal have a default session-rate cap of $2,500. If the amount (or full rate, when set) exceeds your practice’s effective cap, an inline error appears on the amount field. Submit stays disabled until the amount is reduced to the cap or less. If your practice regularly needs to charge more than $2,500 per session, contact Thrizer support for prior review. Thrizer may approve a higher practice-specific cap, up to the absolute maximum of $25,000. Once approved, the higher cap applies to every clinician on the team. A Thrizer administrator can still process an individual one-off oversized charge on your behalf.

​

Can insurance be billed for sessions scheduled far in the future?

No. OON Pay and Thrizer Pay are only available when the Date of Service is today or tomorrow. This is a calendar-date restriction, not a rolling 24-hour window. Sessions two or more calendar days ahead cannot be billed to insurance through Thrizer. In Add Charge, picking a date more than one day ahead disables OON Pay and Thrizer Pay in the payment type dropdown and switches the form to Self-Pay. An insurance charge with a missing date, or a date more than one day ahead, is not accepted. Self-Pay works for any future Date of Service. To bill insurance, create the charge on the day before or the day of the session.

​

Can no-show or cancellation fees be submitted to insurance?

No. No-show and cancellation fees cannot be submitted to insurance through Thrizer. Clinicians may charge clients directly for missed or canceled sessions, but those charges are handled separately from insurance reimbursement. They should be treated as Self-Pay charges. Because no-show and cancellation fees are not submitted as insurance claims, clients should not expect reimbursement for those charges through Thrizer.

​

Can clients submit claims for past sessions?

Not through the Client Portal. Client-side Upload Superbill and Add Claim were retired from the Client Portal on August 9, 2026. If a client has a superbill from a session that was not paid through Thrizer, they can pursue reimbursement by submitting the superbill directly to their insurer. Thrizer does not accept or submit client superbills. Insurers still determine whether to accept a claim. Insurance plans may have timely filing limits, and Thrizer does not guarantee that an older claim will be accepted or reimbursed.

​

Can I correct the wrong CPT code or other claim detail after submission?

Once a claim has been submitted to insurance, you cannot edit that claim directly from the Clinician Portal. If a claim was submitted with an incorrect CPT code, diagnosis code, service date, or other detail, Thrizer support may be able to review the claim and help correct or resubmit it where possible. Thrizer does not guarantee that the insurer will accept a corrected claim, approve it, or reimburse it. Insurer timely filing rules and re-processing rules still apply.

​

Can a denied claim be corrected and resubmitted?

Thrizer support may review the denial and help correct or resubmit the claim where possible. Insurer acceptance, approval, and reimbursement are not guaranteed. You cannot edit or resubmit a denied claim directly from the Clinician Portal.

​

Can I see why a claim was rejected?

Yes. When a claim is Rejected, the claim detail drawer in the Clinician Portal shows a reason from the clearinghouse or payer where one is available. The Results row reads as Claim Rejected: {reason}, and, when the payer returned an additional status message, includes that message as a second sentence. Reasons come from two sources:

• Thrizer’s clearinghouse. Some claims fail before reaching the payer, for example a bad Tax ID or a missing billing NPI. These are now marked Rejected immediately with a reason that names the failing field. They previously showed as Submitted or Pending until support investigated.
• The payer’s 277 response. When the payer returns a claim as unprocessable, the reject shows the payer’s category and status text (for example, Returned as unprocessable; Entity not approved) plus any sanitized status message the payer included.

Use the reason to decide next steps. If it points to a field you can fix on the client or clinician record (such as a TIN or NPI), correct it and let Thrizer support know so the claim can be resubmitted. If the wording is payer-specific and unclear, note the exact text the payer returned. The Client Portal shows only a generic rejected message and does not include the clearinghouse or payer reason. See Claims and superbills for clinicians for more on reading rejected claim details.

​

How do I cancel a charge or a claim?

A completed charge is refunded rather than canceled. Refunding a charge and canceling or correcting an associated insurance claim are separate actions.

• If you refund the charge, the payment is returned according to the applicable refund rules. The refund does not automatically cancel, prevent, void, or correct an associated claim.
• If the claim also needs to be canceled or corrected, contact Thrizer support through your Thrizer account. Include the client, charge or claim, date of service, requested action, and reason.

Thrizer support can review the claim and, where possible, request the cancellation or correction. Insurer acceptance is not guaranteed.

​

I accidentally charged twice for one session

If you charge the same session twice, refund the duplicate charge from the Clinician Portal. If that charge generated an insurance claim, request cancellation of the duplicate claim separately. Do not assume the refund canceled the claim. Only the duplicate transaction is affected by the refund. The remaining, correct charge and its claim continue to process normally. If you do not see the refund option, ask your Practice Administrator to issue the refund. If the Practice Administrator also cannot see the option or the refund fails, contact Thrizer support through your Thrizer account.

​

Can I correct a wrong CPT code on a denied claim?

Once a charge has been submitted and a claim generated, you cannot edit the claim directly from the Clinician Portal. If you submitted the wrong CPT code (or another claim field), Thrizer support may be able to review the claim. Depending on the situation, they can help correct the information or resubmit the claim where the payment type allows. A support review does not guarantee insurer acceptance, approval, or reimbursement. The insurance carrier still determines the final claim outcome. That includes whether a corrected or resubmitted claim is accepted under the insurer’s rules and timely-filing limits.

​

Can Thrizer fix or resubmit a superbill that was already sent to insurance?

No. Thrizer cannot take over, correct, appeal, or resubmit a superbill claim that has already been submitted to insurance through another path. If a superbill was already submitted to insurance and the client believes it was reimbursed incorrectly, the client needs to work through the insurer or the original submission path. Submitting the same claim again through another path may create a duplicate-claim issue.

​

Can clinicians upload superbills for clients?

No. A clinician cannot submit a superbill to insurance on a client’s behalf through Thrizer. Clinicians can generate a superbill PDF only for Self-Pay sessions, and the client submits that superbill to their insurer directly. Thrizer does not submit client superbills on their behalf. Superbill generation by clinicians is not available for OON Pay or Thrizer Pay. For OON Pay and Thrizer Pay, claim submission happens automatically after a successful charge when the payment type supports claim submission.

​

Does Thrizer support secondary insurance?

No. Thrizer supports primary insurance only. Secondary insurance and coordination of benefits are not supported. If a client has more than one insurance plan, Thrizer cannot automatically coordinate claims across multiple insurers.

​

Can practices split payouts between clinicians?

No. Thrizer does not support automated revenue splits between clinicians. Each team has one linked payout bank account. If a practice needs to divide payments among clinicians, that needs to be handled outside of Thrizer.

​

What Thrizer does

Thrizer can help process supported payment options, submit claims when the payment type supports claim submission, and track claim status. For OON Pay and Thrizer Pay, claim submission happens automatically after a successful charge when the required claim information is present. Client-side Upload Superbill and Add Claim were retired from the Client Portal on August 9, 2026. Claims already submitted through those paths continue to process normally.

​

What insurance determines

Insurance carriers determine claim acceptance, claim approval, deductible application, reimbursement amount, and reimbursement timing. Thrizer does not guarantee claim approval, reimbursement amount, deductible application, or claim timing.

​

Related articles