Manual benefit checks

​

When to request help

Request manual verification when an automated benefit check repeatedly fails, returns incomplete information, or conflicts with the client’s insurer records. Start with the practice-side request below. Clients can also contact Support directly; they do not need the practice’s permission. For result meaning and reliability, see What is a benefit check?.

​

Why manual benefit checks may be needed

This can happen when:

• the insurance information does not exactly match the insurer’s records
• the insurer did not return complete benefit details
• required benefit fields (such as deductible status, coinsurance, allowed amount details, or out-of-network reimbursement rules) are missing
• behavioral health benefits are handled by a separate administrator and were not included in the response
• the insurer does not share detailed out-of-network benefits through automated tools
• the insurer’s system timed out or returned only limited information
• the plan recently changed and insurer systems have not finished updating
• the plan requires manual phone verification

​

How to request a manual benefit check

Practice steps:

1. Open Clinician Portal → Clients and select the affected client.
2. Open Insurance. When benefits are unknown, select Contact Support to open Manual Client Benefits Check.
3. Complete the form and submit the request. The same form is available from Help → Benefit Check Request in your account.

Use a client profile your role can access. Staff Members can handle clients in their practice; Clinicians use their own client connections. Requesting a check does not grant permission to edit insurance or other client settings. If the form is not working, contact Support through your account for help. Manual verification is not started from the public Widget. Client route: Clients can contact Support through their own Thrizer account and request a manual check. Ask them to include the clinician’s name. For a client who cannot sign in, use the login and Support guidance, including an available Support option on the current screen.

​

What information may be needed

The Manual Client Benefits Check form requires:

• the client’s full name
• the client’s date of birth
• the front of the insurance card
• the back of the insurance card

Support can also ask for corrected insurance information if the details do not match insurer records. These details help identify the plan and request missing benefit information.

​

What a manual benefit check tries to confirm

A manual benefit check tries to confirm whether the client’s insurance information can be used with Thrizer. That may include confirming:

• whether benefit information can be obtained
• whether out-of-network benefit details are available
• deductible information
• coinsurance information
• whether reimbursement estimates can be generated
• whether claim submission can be supported for that client and insurance plan

​

Does a failed automated check mean there is no coverage?

No. A failed or incomplete automated benefit check does not, by itself, mean there is no coverage. Some insurance systems do not return complete out-of-network or behavioral health benefit details through automated tools. Sometimes an insurer may confirm general medical eligibility while leaving out behavioral health benefit information. In those cases, manual verification may be needed before Thrizer can interpret the benefits safely.

​

What happens after manual verification

If benefit information can be obtained and is complete enough, Thrizer may be able to support claim processes and generate reimbursement estimates. If benefit information cannot be obtained through either automated or manual verification, Thrizer cannot support OON Billing for that client. Self-Pay remains available.

​

What if the plan is labeled HMO, Medicare, or Medicaid?

An HMO label alone does not settle whether a commercial plan has a usable out-of-network benefit exception. Manual verification can review unclear information, but cannot enable an excluded insurance program. Use Can my client use insurance with Thrizer? for the complete HMO and Medicare/Medicaid boundaries.

​

What Thrizer does

Thrizer checks the available information to establish whether benefits are usable. It does not fill in missing fields by assumption.

​

What you can share with your client

Use this when an automated check needs manual follow-up.

The automated check didn’t return enough information, so we can request a manual review. Please have your full name, date of birth, and the front and back of your insurance card ready. You can also request the check through Support in your payment portal account and include my name. A manual check helps us understand your benefits; your insurer still decides the claim outcome.

​

What insurance determines

The insurer decides coverage, claim approval, the final allowed amount, deductible application, reimbursement, and timing. Use What is a benefit check? to explain which parts of the result are estimates.

​

Related articles