> ## Documentation Index > Fetch the complete documentation index at: https://docs.thrizer.com/llms.txt > Use this file to discover all available pages before exploring further. # Manual benefit checks > Learn why Thrizer may need to manually verify insurance benefits, what information may be needed, and what a manual check can and cannot confirm. ## When to request help Thrizer may need to manually check insurance benefits when automated insurance systems do not return enough information. This does not automatically mean the client does not have coverage. It usually means the available benefit information is incomplete, unclear, or not reliable enough to use for claim submission or reimbursement estimates. A manual benefit check helps Thrizer determine whether enough benefit information is available to support claim submission and reimbursement estimates. Benefit checks are still estimates. The insurance carrier makes the final decision on coverage, claim approval, reimbursement, deductible application, and timing. ## Why manual benefit checks may be needed A manual benefit check may be needed when automated insurance verification fails, returns only limited information, or leaves out important benefit details. 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 expose 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 An automated failure is not the same as a coverage denial. It only means the automated check did not return enough usable information. ## How to request a manual benefit check **Clinicians:** request one from the Clinician Portal at **Help → Request Benefit Check**. **Clients:** email [help@thrizer.com](mailto:help@thrizer.com) and ask for a manual benefit check. It usually helps to include your clinician's name so support can connect the request to the right account. ## What information may be needed Thrizer may ask for additional insurance details so the plan can be verified manually. This may include: * the front of the insurance card * the back of the insurance card * the client’s date of birth * corrected insurance information, if the submitted details do not match insurer records These details help Thrizer identify the plan and request the 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 insurance-based payment types (OON Pay, Thrizer Pay, or claim submission) for that client. Self-Pay remains available. ## What if the plan is labeled HMO, Medicare, or Medicaid? If a benefit check or the widget returns usable out-of-network benefit information, Thrizer can generally support claim submission for that plan. This applies even when the plan is labeled HMO, Medicare, Medicaid, or another type that clients sometimes assume is not supported. HMO plans generally do not include out-of-network benefits, but rare plan-level exceptions exist. If you or your client believe the result looks inconsistent with the plan type, request a manual benefit check so support can review it before relying on it. ## What Thrizer does Thrizer uses automated and, when needed, manual verification to try to obtain enough benefit information to support eligible Thrizer payment types. Thrizer may use benefit information to help estimate reimbursement or client cost before a claim is processed. Thrizer does not fill in missing benefit fields by assumption. ## What insurance determines The insurance carrier determines the final claim outcome. A manual benefit check does not guarantee: * coverage * reimbursement * claim approval * final allowed amount * deductible application * claim timing The final outcome is determined by the insurance carrier after a claim is processed. ## Related articles Learn what a benefit check is, what it estimates, and why it is not a guarantee. See how clinicians can run an automated benefit check before manual review is needed. Understand when insurance may be usable with Thrizer and why plan details still matter. Learn why Thrizer Pay depends on verified benefit information and other eligibility rules. Understand why benefit check estimates may differ from the insurer’s final claim decision.