Clinician payout protection and clawbacks

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No clinician clawbacks for insurance outcomes

Thrizer’s policy is no clinician clawbacks for insurance outcomes. If a claim is denied, reimburses less than expected, applies to the client’s deductible, or results in $0 reimbursement, Thrizer does not reverse your payout because of that claim outcome.

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Can Thrizer claw back a clinician payout if a claim is denied?

No. Thrizer does not reverse your payout because of:

• a claim denial
• a reimbursement shortfall
• reimbursement variance from the original estimate
• $0 reimbursement (for example, when the claim was applied to the client’s deductible)

This protection covers insurer-driven outcomes. It does not apply to a refund you initiate. A refund you initiate can still reverse the refunded transaction amount from your payout. See The main exception: clinician-initiated refunds below. Your payout timing is also separate from insurer reimbursement timing. You do not wait for insurance to process a claim before receiving payout through Thrizer.

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How this works for Thrizer Pay

This is especially important for Thrizer Pay, because Thrizer advances part of the session fee before insurance finishes processing the claim. With Thrizer Pay:

• the client pays an estimated out-of-pocket responsibility upfront
• Thrizer advances the rest of the session fee to you
• Thrizer submits the claim and receives any insurance reimbursement
• Thrizer carries the reimbursement risk relative to you

If the final insurance result differs from the estimate, your payout is still protected. Where applicable, Thrizer handles any adjustment on the client side — for example, with an additional client charge, a client refund, or updated estimates for future sessions. Thrizer does not handle it by clawing back your payout. Your payout is not reduced later if insurance:

• denies the claim
• reimburses less than expected
• reimburses $0
• applies the claim to the client’s deductible

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How this works for OON Pay

With OON Pay, the client pays the full session fee upfront and Thrizer routes any insurance reimbursement back to the client. Because you are paid from the client’s upfront payment rather than from a Thrizer advance, insurance outcomes also do not reverse your payout under OON Pay.

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The main exception: clinician-initiated refunds

The main exception to payout protection is a refund you initiate. If you refund a transaction, the refund can reverse the refunded transaction amount from your payout. The client receives a refund for the amount originally charged, and Thrizer reduces your payout by the refunded amount. This is separate from an insurance-related clawback. It is driven by your own refund action, not by an insurer claim outcome. Thrizer Pay refunds are full-refund only. Thrizer Pay does not support partial refunds. The refund drawer refunds the full charge, reduces your payout by the full gross bill amount, and cancels the associated claim. See Thrizer Pay refunds are full-refund only for details.

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Common clawback questions

Can Thrizer claw back a clinician payout if a claim is denied? No. A denied claim does not reverse your payout. What if the claim reimburses less than expected, or reimburses $0? No clawback. Reimbursement shortfalls, reimbursement variance, deductible application, and $0 reimbursement do not reduce your payout. What if the insurer applies the claim to the client’s deductible? No clawback. Deductible application is an insurance outcome, not a payout reversal event. What is the exception? A refund you initiate. If you refund a transaction, Thrizer reverses the refunded amount from your payout. This is not an insurance-driven clawback — it is your own refund action.

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What this does not cover

Payout protection is specifically about insurer claim outcomes. It does not mean Thrizer never reverses a transaction under any circumstance. Other situations, such as refunds you initiate (described above), can still reduce your payout. If you have a question about a specific transaction, reach out to help@thrizer.com.

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