Set a Default Modifier for Insurance Claims

When an insurance company requires a provider’s claims to always include the modifier, TherapyAppointment can enable you to include the modifier on those claims automatically.

Required Role:

Owner or Manager

Some of examples of when having a default modifier go on a claim is useful:

  • Billing Optum EAP: the Modifier HJ must always be included on the claim
  • If you have a practice that is 100% teletherapy: Teletherapy claims typically require a modifier
    • Example: 95 or GT depending on the insurance company being billed

Adjust the Insurance Company Settings

To always include a modifier on a claim for a particular insurance company, go to:

  • Practice Settings (left menu)
  • Click Billing & Insurance (top tab)
  • Find the section Insurance Features
  • Click the far right button:

  • Click the Name of the insurance company, loading the insurance company settings:

Are you a solo provider using our system?

If so, it should bring you to this page: click here to go to that section and pick up there.

  • Near the bottom, find the section Therapist Claim Options (last section)
  • To the right of the provider name, click the button:
    • Either or

  • Enter the modifier code into the Service Modifiers box (top option) from left to right
    • Include both digits in a single box
    • Example shown below: HJ
  • Scroll to the bottom right and click

check_circle Going forward, whenever a claim is generated for this specific insurance company by said provider, the modifier will automatically be included on those claims.