How Thrizer Pay Works

Paying for out-of-network therapy can be stressful. Many people are asked to pay the full session fee upfront, wait weeks for reimbursement, and manage insurance paperwork along the way.

Thrizer Pay is designed to make this easier.

With Thrizer Pay, clients can pay only their expected out-of-pocket cost ("co-pay") at the time of each session, instead of paying the full fee upfront and waiting for insurance reimbursement. Thrizer handles claim submission and insurance follow-ups behind the scenes.

The goal is simple: help clients hold on to more of their cash, reduce administrative burden, and provide peace of mind for both clients and clinicians.

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Why Thrizer Pay exists

Out-of-network therapy often requires clients to:

• Pay hundreds of dollars upfront
• Wait weeks or months to be reimbursed
• Track claims and explanations of benefits
• Follow up with insurance when something feels unclear

This process can create unnecessary financial and emotional strain.

Thrizer Pay reduces this friction by estimating coverage upfront and managing the claims process on the client’s behalf, so clients can focus on their care instead of their cash flow.

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When Thrizer Pay is available

Thrizer Pay is available once:

• The client’s deductible has been met AND
• At least one claim has been successfully process

This two items together mean that coverage has been verified concertely and the client is being actively reimbursed.

Once enabled, Thrizer Pay can be used for every session.
It can be initiated by either the client or the clinician.

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How payment works (with an example)

Here is a simple example to show how Thrizer Pay works in practice.

Example

• Session fee: $200
• Allowed amount: $150
• Co-insurance: 20%
• Deductible: already met

Coverage

• Insurance pays: $120 (80% of $150)
• Client’s out-of-pocket responsibility (co-pay): $80 ($200 - $120)

With Thrizer Pay

• Thrizer Pay includes a 5% fee based on the session cost
  • On a $200 session, this fee is $10
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• The client pays a total of $90 at the time of the session
  • $80 out-of-pocket cost
  • $10 Thrizer Pay fee

Thrizer then floats the remaining fee to the provider, submits the $200 claim to insurance, and waits for the $120 reimbursement from the plan.

There are no surprise charges or adjustments to the client after payment.

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How Thrizer handles differences in coverage

Insurance reimbursement is ultimately determined by the insurance carrier. Thrizer Pay is designed to protect clients from unexpected outcomes after payment.

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If coverage is better than expected

If insurance reimburses more than anticipated:

• Thrizer refunds the difference to the client

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If coverage is worse than expected

If insurance reimburses less than anticipated:

• The client is not back-charged
• The client still pays only the original amount

Thrizer absorbs the difference so clients are not surprised later.

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Coverage updates automatically

As claims are processed:

• Allowed amounts and benefit details become clearer
• The client’s Thrizer profile updates automatically
• Future Thrizer Pay estimates reflect actual coverage more accurately

This helps reduce uncertainty over time.

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If claims are repeatedly denied

If insurance claims are repeatedly denied:

• Thrizer Pay may no longer be available for that client
• This decision is based on coverage reliability, not behavior

Standard claim submission can still continue even if Thrizer Pay is no longer available.

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What this means for clients

• You do not have to pay the full session fee upfront
• You can keep more of your cash available between sessions
• Thrizer manages claims and insurance follow-ups
• You are protected from surprise charges

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What this means for clinicians

• Clients face fewer financial barriers to starting and continuing care
• Payment expectations are clearer and more predictable
• Thrizer manages claim submission and reconciliation
• Thrizer Pay is available only when coverage can be verified

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Important note

Thrizer Pay is based on benefit estimates and information provided by insurance carriers. Final reimbursement decisions are always made by the insurer.

Thrizer Pay does not change insurance rules, coverage requirements, or claim outcomes.