Can I use my insurance with Thrizer?

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Overview

Thrizer works with out-of-network (OON) benefits, not in-network insurance. If your plan includes out-of-network coverage for the type of care you receive, Thrizer can check estimated benefits and submit eligible OON claims. Any reimbursement is routed to you. If your plan does not include out-of-network benefits, you can still use Thrizer as a Self-Pay payment platform — no claim is submitted in that case. Benefit checks and cost estimates are not guarantees. Your insurance plan determines final coverage, claim approval, deductible application, reimbursement amount, and timing.

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How it works

1. Your clinician shares a Thrizer link or invites you to a Thrizer account.
2. You add your insurance information so Thrizer can run a benefit check.
3. If a usable benefit check comes back, Thrizer shows estimated out-of-network benefits and your estimated session cost.
4. After your clinician charges a session, Thrizer submits the out-of-network claim to your insurance (for OON Pay and Thrizer Pay).
5. The insurance carrier processes the claim and determines the final outcome.

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When insurance can be used with Thrizer

You can typically use your insurance with Thrizer when all of the following apply:

• Your plan includes out-of-network benefits for the type of care.
• The provider type and service are within Thrizer’s supported scope.
• A usable benefit check completes (either automatically or after manual verification).
• Your insurance information links successfully to your account.

If a benefit check cannot be completed, Thrizer cannot estimate coverage or submit a claim through insurance. Self-Pay remains available in that case.

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When insurance may not work with Thrizer

• In-network only plans generally do not work with Thrizer because Thrizer focuses on out-of-network benefits.
• No out-of-network benefits on the plan means there is nothing for Thrizer to bill.
• HMO plans generally do not include out-of-network benefits, but rare plan-level exceptions exist. If a benefit check returns usable out-of-network benefit information for an HMO plan, the plan can still be considered.
• Government plans such as Medicare, Medicaid, and Tricare often do not include the out-of-network benefits Thrizer relies on. They may still be usable if a benefit check returns enough out-of-network benefit information for the plan.
• Medicare Advantage and commercially administered Medicare-related plans typically require manual benefit verification. Do not assume support from the plan name alone. Thrizer does not credential clinicians or “make” a clinician out-of-network with any insurer. See Which insurance companies does Thrizer work with? for details.
• Secondary insurance is not currently supported as a billable insurance source.
• A failed automated benefit check is not a coverage denial — manual verification may still confirm benefits.

Plan type alone does not decide whether Thrizer can be used. What matters is whether a benefit check is usable for that specific plan. Insurance carriers determine final coverage and claim outcomes.

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What is estimated vs final

• Estimated: benefits returned from a benefit check, estimated session cost, estimated reimbursement.
• Final: claim approval, allowed amount, deductible application, reimbursement amount, and processing time — all determined by your insurance carrier.

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