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.

This setting may be adjusted by users with an Owner or Manager Role in TherapyAppointment 2.0

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 (such as 95 or GT, depending on the insurance company being billed).

How to adjust the insurance company settings to ALWAYS include a Modifier on a claim by default:

Go to Practice Settings

Select Billing and Insurance tab

Insurance Features – Manage Companies: 

Select the insurance company from the list in the library. 

Scroll Down to the Therapist Claim Options for the Insurance Company Selected and Select the ‘Claim settings’ besides the therapist who must have the HJ modifier included on the claims. 

Enter the Modifier Code into the Service Modifiers Box on the Left, placing both digits of the modifier in a single box. Modifiers are always 2-digits). Be sure and Save your change. 

Now, whenever a claim is produced for said insurance company by said provider, the modifier will default to being included on the claim.