Claims and superbill uploads

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Overview

Use Claims to view submitted claims and submit superbills when you are using a superbill-based payment option.

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If my clinician said payments are automatically claimed, do I need to submit anything?

Usually no. When your clinician uses OON Pay or Thrizer Pay, Thrizer submits the out-of-network claim automatically after the charge processes successfully. Automatic submission requires the claim information on file. You do not need to upload a superbill manually for those sessions. You would only submit a claim yourself (through Superbill Upload or Add Claim) in these cases:

• The session was Self-Pay.
• Your clinician does not use Thrizer for that session.
• Thrizer support tells you a manual submission is needed.

If you just need a superbill PDF for a Self-Pay session you already paid in Thrizer, you can generate one from Client Portal → Payments. Use Generate Superbill to export a batch matching your current filters, or use the Export Superbill row action on a single Confirmed Self-Pay payment. See Viewing payments and exporting receipts for details.

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Where do I see my automatically submitted claims?

Automatically submitted OON Pay and Thrizer Pay claims appear under: Client Portal → Claims Each claim shows Submission Date, Claim #, Appointment Date, Clinician, Amount, and Status. If you expected an automatic claim to appear here but do not see it, possible reasons include:

• The payment failed. No payment means no claim is submitted. Ask your clinician to retry the charge after updating your payment method.
• The session was Self-Pay. Self-Pay does not generate an insurance claim. Use Superbill Upload if you want to submit a claim yourself.
• Required claim information is missing. For example, missing diagnosis, CPT, NPI, or billing details on the clinician’s side.
• Your insurance is not verified. A usable benefit check is required before automatic claim submission.
• The claim is pending Thrizer support review. Some claims are held for manual review before they appear.

If none of these apply and the claim is still not visible after a few business days, contact help@thrizer.com.

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Where to go

Go to: Client Portal → Claims You can also start a superbill upload from Home using Upload Superbill.

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Claims list

The claims list shows:

• Submission Date
• Claim #
• Appointment Date
• Clinician
• Amount
• Status

To find a specific claim, use the search box on the Claims page to search by clinician name or claim number.

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Claim details

Select a claim number to open claim details. The details view shows an overview of the claim.

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Upload a superbill

Select Upload Superbill to open the upload drawer. Drop a PDF into the drop zone and select Upload & Parse. Thrizer parses the uploaded PDF and creates claims from the superbill.

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Before you upload

• Superbill Upload accepts one file per upload. If you have multiple separate superbills, upload each one separately.
• A superbill PDF may include multiple sessions. If it does, the fee is $2 per session, not $2 per PDF.
• A Superbill Upload fee of $2 per session applies. If the insurance carrier denies the resulting claim, Thrizer refunds the fee.
• A superbill cannot be submitted through Thrizer if the same claim has already been submitted to insurance another way.
• A clinician cannot upload a superbill on your behalf. Superbill upload is a client action from your own Thrizer account.

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I have 3 separate bills or superbills. How do I upload them?

Upload each superbill separately using Upload Superbill. Do not combine unrelated superbills into a single PDF. If a single superbill lists multiple sessions from the same provider, upload that one PDF once — the fee is $2 per session included on the superbill. See Self-Pay and superbills and How to submit a claim for more detail.

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Can I submit a claim for a therapist or provider who is not on Thrizer?

Yes. You can submit an out-of-network claim through Thrizer for a provider who does not use Thrizer, as long as you have the required superbill information from that provider. Use one of the following:

• Upload Superbill — upload the superbill PDF from that provider.
• Add Claim — enter the claim details manually (requires linked insurance).

Requirements and expectations:

• You need a valid superbill or the claim information the insurer needs (provider name, provider NPI, tax ID or TIN, service date, billed amount, CPT code, one or more diagnosis codes).
• Reimbursement is not guaranteed. Insurance carriers determine claim approval, reimbursement amount, deductible application, and processing time.
• Insurer timely filing rules still apply. A claim submitted too long after the service date may be denied by the insurer.
• Your clinician does not need to be on Thrizer for you to submit a superbill or manual claim.

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Add a claim manually

Select Add Claim to add a claim manually. Manual claim entry requires linked insurance. If insurance is not linked, select Link insurance to go to insurance settings.

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What a superbill should include

A valid superbill should include the information needed for claim submission, including provider details, service dates, billed amount, one or more diagnosis codes, and CPT code.

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