Out-of-Network / Courtesy Claims

Understanding Courtesy Claims

What are Courtesy Claims, and Why Should You Provide Them? 

If you are not currently paneled with insurance companies, you may be providing superbills to your clients so that they can self-file with their insurance companies* for reimbursement. If their insurance plan offers coverage for ‘out-of-network benefits’ they may likely have a portion of the cost of their session reimbursed to them. There is only one problem with this: Clients often come to therapy because they are already extremely overwhelmed, and ‘one more task’ may stress them even further right now. They might even ‘pass your business by' in their search for help because you don’t file on their insurance.

Did you know that you can help your clients file for their out-of-network benefits by filing the claim for them? For your part, it takes only the ‘push of a button’ in TherapyAppointment yet provides a valuable service to your current and potential clients that you can market for your business. Our process below will instruct the insurance company to remit any payment directly to the client. 

⚠️ Note: You must get pre-authorization to bill out of network claims to Medicare, Medicaid and most government plans.

Out-of-Network Settings

The following process will direct insurance companies to make any payments directly to the client, from an insurance company. It assumes that you are collecting the session fee from the client. 

Ensure that you have enabled claims processing in your TherapyAppointment account.  Learn how to add an insurance company to be billed here.

  • Click Practice Settings (left menu)
  • Select Billing & Insurance (top tab)
  • Navigate to the 'Insurance Features' section
  • Click the button
  • Search for, or select , for the desired insurance company. 
  • Within the 'Group Claim Options' section, check 'No' for Accept Assignment

  • For the line item Include Amount Paid, select 'Yes' from the drop-down
  • Save changes

Schedule the client for a session, complete the notes, and the claim will be automatically generated. For End of Day, review the Claims Tracking Tool within the Billing & Insurance screen, or from the Dashboard. The claim is ready to be submitted!

Related Articles