Self-Pay and superbills

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Overview

Self-Pay means the client pays the full session fee without using insurance through that payment flow. Thrizer doesn’t submit an insurance claim automatically and doesn’t send reimbursement through Thrizer. Thrizer also doesn’t apply a client insurance-related fee to the Self-Pay payment itself. Standard card processing fees on the clinician side still apply. A superbill is different. A superbill is a document a client can use to submit claim information separately for possible out-of-network reimbursement or deductible credit. Reimbursement is not guaranteed, and the insurance carrier decides the final claim outcome.

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When would I use Self-Pay?

Use Self-Pay when a session is paid without insurance involvement through Thrizer. With Self-Pay:

• the client pays the full session fee
• no claim is automatically submitted
• no reimbursement is expected through that payment flow
• no insurance information is required for the Self-Pay payment
• no diagnosis code is required for the Self-Pay payment

For example, a client may use Self-Pay when they are not using insurance for the session or when no claim will be submitted through Thrizer.

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Does Self-Pay create an insurance claim?

No. Self-Pay does not create an insurance claim. That means the client should not expect claim tracking, deductible credit, or reimbursement from the Self-Pay payment itself. If the client wants to pursue reimbursement separately, they may need to submit claim information separately, such as by using a superbill.

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What is a superbill?

A superbill is a document with information an insurance carrier may need to process a claim. A valid superbill generally includes information such as:

• provider name
• provider NPI
• tax ID or TIN
• service date
• billed amount
• one or more diagnosis codes
• CPT code

The insurer uses the submitted claim information to decide whether the service is eligible for reimbursement or deductible credit.

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Can a client submit a superbill through Thrizer?

Not through the Client Portal anymore. Client-side Upload Superbill and Add Claim were retired on August 9, 2026. If your clinician is on Thrizer and uses OON Pay or Thrizer Pay, they submit claims on your behalf automatically after the charge processes. If you have a superbill from a provider who is not on Thrizer, submit it directly to your insurer. Thrizer does not accept or submit client superbills. If a superbill was already submitted to insurance through another path, Thrizer cannot take over, correct, appeal, or reprocess that claim. The client needs to work through the insurer or the original submission path. If reimbursement is issued for a claim that Thrizer submits on your behalf, it is sent to the client following the same rules as before.

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Can a clinician submit a superbill for a client?

A clinician on Thrizer submits claims for their own clients automatically through OON Pay or Thrizer Pay. A clinician cannot submit a superbill on a client’s behalf for a session that was not paid through Thrizer. If a client has a superbill from a provider who is not on Thrizer, they submit it directly to their insurer. Thrizer does not accept or submit client superbills.

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Does a superbill guarantee reimbursement?

No. A superbill does not guarantee reimbursement. The insurance carrier decides whether the claim is accepted, denied, applied to the deductible, or reimbursed. Claims may also be subject to the insurer’s timely filing rules. A claim can be accepted by the insurer and still result in no cash reimbursement if the allowed amount is applied to the client’s deductible.

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How is this different from OON Pay?

With OON Pay, the client pays the full session fee upfront and Thrizer automatically submits the claim after the charge is successfully processed. If reimbursement is issued, it is routed back to the client. With Self-Pay, no insurance claim is automatically submitted. If the client wants to pursue reimbursement, they submit claim information (such as a superbill PDF) directly to their insurance carrier. Thrizer does not submit client superbills on their behalf.

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How is this different from Thrizer Pay?

With Thrizer Pay, the client pays an estimated out-of-pocket amount upfront, Thrizer advances the remaining session fee to the clinician, and insurance reimbursement is routed to Thrizer. With Self-Pay, the client pays the full session fee, Thrizer does not advance payment based on insurance, and no claim is automatically submitted.

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What should I expect after submitting a superbill?

After a superbill is submitted, the claim outcome depends on the insurance carrier. The claim may be:

• reimbursed
• applied to the deductible
• denied

The final result depends on the client’s plan, the insurer’s rules, the submitted claim details, and any timely filing limits that apply. Thrizer does not guarantee claim approval, reimbursement amount, deductible application, or claim timing.

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What Thrizer does

Thrizer supports Self-Pay payments where no insurance claim is automatically submitted. For sessions paid through OON Pay or Thrizer Pay, Thrizer submits the out-of-network claim automatically on the client’s behalf. Client-side Upload Superbill and Add Claim were retired from the Client Portal on August 9, 2026.

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What insurance determines

The insurance carrier determines whether a submitted claim is accepted, denied, applied to the deductible, or reimbursed. The carrier also determines the reimbursement amount and claim processing timing.

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