> ## Documentation Index
> Fetch the complete documentation index at: https://docs.thrizer.com/llms.txt
> Use this file to discover all available pages before exploring further.
# How to submit a claim
> Learn how claims are submitted through Thrizer, when submission is automatic, and when a client needs to upload a superbill themselves.
## Before you start
Thrizer supports two main claim submission paths:
* Automatic claim submission through OON Pay or Thrizer Pay
* Client-submitted claims through superbill upload
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-based claims, the client submits the claim through their own Thrizer account by uploading a superbill.
**Client Portal changes:** Manual claim entry (**Add Claim**) has been removed from the client portal. Client-side **Upload Superbill** is still available but will be discontinued on **August 9, 2026**. See the [July 22, 2026 update](/help/changelog/2026-07-22).
In all cases, the insurance carrier determines the final claim outcome, reimbursement amount, deductible application, and processing timing.
## How this works
The right claim submission path depends on how the session was paid for and whether Thrizer is handling claim submission.
If the session is processed through OON Pay or Thrizer Pay, the claim submission process is automatic after successful payment.
If the client has a superbill, the client may upload it through Thrizer while client-side upload remains available. The client may also submit the superbill directly to insurance outside of Thrizer.
## When is a claim submitted automatically?
Claims are submitted automatically for:
* OON Pay
* Thrizer Pay
In these payment flows, the clinician creates a charge for the session. Once the client’s payment is successfully processed, Thrizer submits the claim to insurance using the information attached to that charge.
There is no separate manual claim submission step for OON Pay or Thrizer Pay.
## What happens if the payment fails?
If the client’s payment does not go through, the charge fails and the claim is not submitted.
Resolve the payment issue with the client, then retry the charge. Thrizer submits a claim only after payment succeeds.
## When does a client submit a claim themselves?
A client may submit a claim themselves by uploading a superbill through their client portal.
This may apply when:
* the clinician is not using an automatic claim submission flow
* the session happened outside an OON Pay or Thrizer Pay charge
* the client has a superbill and wants Thrizer to submit the claim from that document
Client-submitted claims are client-driven. The client must have their own Thrizer account to upload a superbill.
Client-side **Upload Superbill** will be discontinued on **August 9, 2026**. After that date, if your clinician is on Thrizer, they can continue submitting claims on your behalf through OON Pay or Thrizer Pay. Manual claim entry (**Add Claim**) is no longer available in the client portal.
## Can a clinician upload a superbill for a client?
No. Superbill upload for claim submission is a client-driven process.
A clinician may provide a superbill to the client, but the client is responsible for uploading the superbill through their own Thrizer account.
## What information does a claim need?
Claims generally need enough information for the insurance carrier to process the service.
A superbill or claim entry should include:
* provider name
* provider NPI
* tax ID or TIN
* service date
* billed amount
* one or more diagnosis codes
* CPT code
If required information is missing or incorrect, the claim may be delayed, fail, or be denied by the insurer.
## What if the session was Self-Pay?
Self-Pay means no insurance claim is automatically submitted through Thrizer.
In a Self-Pay charge, the client pays for the session without automatic Thrizer claim submission. A clinician may generate or provide a superbill for the client.
The client may then choose to:
* submit the superbill directly to insurance outside of Thrizer, or
* submit the claim through a supported Thrizer superbill upload from their own client account (available until **August 9, 2026**)
Thrizer is not involved in claim submission or reimbursement processing unless the client separately submits the superbill or claim details through a supported Thrizer claim process.
## Can claims for past service dates be submitted?
Yes. Clients may submit claims for past service dates by uploading a valid superbill while client-side upload remains available.
However, insurance carriers have their own timely filing rules. If a claim is submitted too late under the insurer’s rules, the insurer may deny it. Thrizer does not guarantee that a claim for a past service date will be accepted or reimbursed.
## What happens after a claim is submitted?
After a claim is submitted, the insurance carrier processes it.
The claim may result in:
* reimbursement
* application toward the deductible
* denial
An approved claim does not always mean money will be reimbursed. If the deductible has not been met, the claim may be approved and applied to the deductible instead.
The insurance carrier controls claim processing time. Typical reimbursement timing may be around 4 to 6 weeks, but timing is not guaranteed.
## Why weren't some of my sessions submitted as claims?
Claim submission through OON Pay or Thrizer Pay requires **both**:
1. a successful client payment (the charge went through), and
2. complete claim-submittable information on file.
Common reasons a session may not have been submitted as a claim:
* **The payment failed.** No payment is captured, and no claim is submitted. The charge must be retried after resolving the payment issue.
* **The session was Self-Pay.** Self-Pay does not automatically generate an insurance claim. If reimbursement is expected, a superbill needs to be uploaded separately.
* **Insurance is not verified.** A claim cannot be submitted if the client's insurance is not linked or the benefit check has not returned usable information.
* **Required claim information is missing.** A missing diagnosis code, missing provider NPI, or another missing required field can block claim submission. You see an inline message in Add Charge when this happens.
* **The service or CPT structure is not claim-compatible.** No-show and cancellation fees cannot be submitted to insurance through Thrizer. Sessions above the \$2,500 cap, or sessions with unrelated CPT codes bundled together, cannot be submitted as a single insurance claim.
* **The Date of Service is more than one day ahead.** OON Pay and Thrizer Pay require a Date of Service of today or tomorrow (UTC). Sessions further out must use Self-Pay.
If none of these apply and a claim is still missing, contact Thrizer support at [help@thrizer.com](mailto:help@thrizer.com).
## Why was my claim denied?
Denial is an insurance-side decision. Common reasons include:
* the service is not covered under the client's plan
* the CPT code, diagnosis code, or provider information does not match insurer records
* the client's plan does not include out-of-network benefits
* the insurer's timely filing window has passed
* documentation or additional information is required
If a claim was denied because of a claim-detail error (for example, wrong CPT code), contact Thrizer support so the claim can be reviewed and, where possible, corrected or resubmitted. Insurer acceptance is not guaranteed. See [Claim and billing limitations](/help/claims/claim-and-billing-limitations#can-a-denied-claim-be-corrected-and-resubmitted).
## Why were some sessions not submitted as claims?
For OON Pay and Thrizer Pay, Thrizer submits a claim only when **both** conditions are met:
1. The charge has been successfully processed (client payment succeeded).
2. All required claim information is present and claim-compatible.
If either condition fails, no claim is submitted for that session. Common reasons include:
* **Payment failed.** If the client's payment method fails, no payment is captured and no claim is generated. Update the payment method and retry the charge.
* **The session was Self-Pay.** Self-Pay does not generate an insurance claim. If the client wants reimbursement, they can submit a superbill through their Client Portal.
* **Insurance is not verified.** A usable benefit check is required. If the automated check failed and no manual verification is complete, Thrizer cannot submit a claim.
* **Required claim fields are missing.** Missing diagnosis, missing individual NPI on the rendering clinician, missing supported CPT, or missing service date can block submission.
* **The service or CPT structure is not claim-compatible.** For example, no-show and cancellation fees are not submitted to insurance. Unrelated services requiring separate CPT codes must be billed as separate charges.
* **The claim is under Thrizer support review.** Some claims are held for support review before submission.
## Why was a claim denied?
Thrizer can accept a claim, and the insurance carrier can still deny it. Denial reasons come from the insurer. Common reasons include:
* Incorrect CPT or diagnosis codes for the plan.
* Out-of-network benefits not applying to the specific plan.
* Timely-filing issues.
* Missing information the insurer requested.
* Plan-specific rules that Thrizer cannot see before submission.
If a claim was denied and you believe the wrong information was submitted, contact [help@thrizer.com](mailto:help@thrizer.com). Support may be able to review and, where possible, help correct or resubmit the claim. Insurer acceptance is not guaranteed.
## What if a claim is delayed or has an issue?
If a claim fails, stalls, or needs more information, Thrizer support may review the issue.
Depending on the situation, Thrizer may request missing information, investigate with the insurer, or help correct and resubmit the claim when possible.
The final decision still belongs to the insurance carrier.
## What Thrizer does
Thrizer helps submit and track claims when the claim is submitted through a supported Thrizer process.
For OON Pay and Thrizer Pay, Thrizer submits the claim automatically after a successful charge.
For client-uploaded superbills, Thrizer uses the information on the uploaded document to generate the claim.
## What insurance determines
The insurance carrier determines final coverage, claim approval, reimbursement, deductible application, and processing timing.
Thrizer does not guarantee claim approval, reimbursement amount, deductible application, or claim timing.
## Related articles
Learn which claim and billing processes Thrizer does not support automatically.
Understand what happens after a claim is submitted and why timing can vary.
Learn how Self-Pay works and when clients may use superbills for claim submission.
See how CPT codes are used when preparing claims through Thrizer.
Learn why diagnosis codes are required before a claim can be submitted.
Compare Self-Pay, OON Pay, and Thrizer Pay before choosing a payment type.