Billing types: Self-Pay and OON Billing

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Start with one question

The Billing Type answers: Will Thrizer submit an insurance claim for this charge?

• Self-Pay: No claim is submitted through Thrizer.
• OON Billing: Thrizer submits an eligible out-of-network claim after the charge is successfully processed.

For OON Billing, you then choose how reimbursement will be handled: Check, Bank, or Instant Reimbursement. Those are Reimbursement Methods, not separate Billing Types.

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Self-Pay

With Self-Pay, the client pays the full Service amount and Thrizer does not submit an insurance claim for the charge. A benefit check is not required. Use Self-Pay for non-billable Services and whenever no insurance claim should be submitted through Thrizer. An otherwise eligible Self-Pay charge for a billable Service may be included in a superbill; the client submits that superbill outside Thrizer.

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OON Billing

With OON Billing, Thrizer submits a claim after an eligible charge is successfully processed. The client needs supported, verified primary insurance, and the charge must contain the required insurance-billing information. OON Billing does not guarantee coverage, claim approval, reimbursement, or a particular reimbursement amount. The insurer makes those decisions.

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Choose with the client

The clinician controls the billing setup in Thrizer, but the choice should reflect the arrangement discussed with the client. First confirm whether the client wants to use insurance. If so, review the Reimbursement Methods Thrizer shows as available for the client’s plan.

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Where to choose a Billing Type

• For the client’s saved setup, open Clinician Portal → Clients, select the client, and stay on Overview. In the Clinician section, select Edit, then choose the Billing type. If you select OON Billing, also choose a Reimbursement method.
• For one charge, open Add Charge and choose the Billing Type for that charge. If you select OON Billing, choose from the Reimbursement Methods Thrizer shows as available.

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