Claims processing timeline

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Short answer

After a claim is submitted through Thrizer, the insurance carrier reviews it and determines the final outcome. Claims typically take about 4 to 6 weeks to process, but timing is controlled by the insurance carrier. A claim may be processing, investigating, approved, or denied. An approved claim does not always mean money will be reimbursed. If the client’s deductible has not been met, the carrier may apply the claim toward the deductible instead of issuing reimbursement.

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How this works

After submission, the claim is sent to the insurance carrier for review. If the claim was created through OON Pay or Thrizer Pay, Thrizer submits the claim automatically after the charge is created and the client’s payment is successfully processed. If the claim was submitted through a superbill upload or manual claim entry, Thrizer uses the information provided in that submission to generate the claim. Once the claim is with the insurance carrier, the carrier determines what happens next.

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How long does claim processing usually take?

Insurance claims typically take about 4 to 6 weeks to process. This is a general timeline, not a guarantee. Some claims may process faster, while others may take longer depending on the insurance carrier, the plan, the claim details, or whether additional review is needed.

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Why is my claim still processing?

A claim may stay in processing while the insurance carrier reviews the submitted information. This does not always mean something is wrong. The carrier may still be reviewing the claim, checking plan rules, determining deductible status, or deciding whether reimbursement is owed. If a claim appears delayed or stops progressing, Thrizer support may review the available claim information and help determine whether follow-up is needed.

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What does an approved claim mean?

An approved claim means the insurance carrier accepted the claim. It does not always mean the client will receive money back. If the client’s deductible has not been met, the insurance carrier will typically apply the claim amount toward the deductible instead of issuing reimbursement. That means a claim can be approved and still result in $0 reimbursement.

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What does it mean if a claim is applied to my deductible?

If a claim is applied to the deductible, the insurance carrier has counted the claim toward the amount the client must pay before insurance begins reimbursing eligible services. In this case, the claim may still be considered processed successfully even if no reimbursement is paid.

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What happens if a claim is denied?

If a claim is denied, the insurance carrier has decided not to reimburse the claim and not to apply it toward the deductible. A denial does not reduce the clinician’s payout for charges processed through Thrizer. It may affect whether the client receives reimbursement or whether certain Thrizer fees are refunded, depending on the payment type and claim outcome.

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What Thrizer does

Thrizer helps submit, track, and support the claim workflow. For OON Pay and Thrizer Pay, Thrizer submits the claim automatically after the clinician creates a charge and the client’s payment is successfully processed. For superbill uploads and manual claim entry, Thrizer uses the submitted information to generate the claim.

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What insurance determines

The insurance carrier decides the final claim outcome. Thrizer does not control whether the carrier approves the claim, denies it, applies it to the deductible, issues reimbursement, or how long the carrier takes to process the claim.

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