Why did I receive a Missing Benefit alert?

Are you seeing a 'Missing Benefit Confirmations' or a  'Needs Confirmation Alert' on your dashboard or Billing Screen? Read details below to understand why.

Missing Benefits Confirmation / Needs Confirmation Alert Explained

The 2.0 system has recognized that you said this client/patient has insurance, but the system cannot find evidence of what the client owes you for their copay/coinsurance amount.

How to Fix the Alert

Clicking on the alert takes you to the client's insurance page, within the client profile. Locate the blue box that reads 'Insurance Benefit Information'. The minimum requirement for dismissing this alert: enter the client’s usual per-session responsibility in the Usual Fee or Copay box. If the amount is zero dollars, enter 0.00 as the amount.

Why Did This Happen?

TherapyAppointment 2.0 is able to assign the client’s responsibility for the service as the amount listed in the Usual Fee or Copay box. Without the usual copay or co-insurance amount listed, the entire responsibility is placed on the client, as due and payable, when that is not likely to be the case.

Locating Patient Copay/Co-Insurance Responsibility Details

Insurance companies typically offer logins to their websites so that you may look up the patient's expected copay/co-insurance amounts due to you at the time of session. Additionally, there is a 'rule of thumb' that can give you an initial 'clue' as to what their responsibility it: Look at a copy of the patients insurance card. If the card lists a standard copay amount for visits to their primary care physician, this is most likely the copay amount that would be due for mental health services. If the insurance card does not include information about a copay on it, it's most likely because this patient has a high-deductible plan where a deductible must be met before insurance pays any portion of your services. In these cases, enter in the insurance company's 'allowed amount' for your services. Although this is a good 'rule of thumb' to get started with, we do highly recommend that you then review the insurance company website for benefits. Additionally, review your initial explanation of benefits for these patients when the first session payments come in from the insurance companies- and, if different than what you listed, adjust the copay/co-insurance amount in the patient's insurance profile accordingly so that you are accurately collecting the correct amount for the next service.