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How Thrizer Pay Makes Therapy Accessible for Everyone

Raunak Sharma
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August 30, 2023

A few weeks ago, we announced the public launch of Thrizer Pay – a revolutionary feature that allows clients to “pay what they owe” for therapy instead of waiting for their insurance to reimburse them.

And the response has been incredible.

Since that announcement, we’ve seen a:

Thrizer’s mission has always been the same: to make high-quality therapy accessible to everyone while empowering providers to earn what they’re worth. 

Thrizer Pay is by far the biggest milestone we’ve had to date in advancing this mission.

And given the response, I wanted to share a bit about how we landed here and why we think this is so big.  

 

Background

 Demand for therapy has SKYROCKETED in recent years. Mental health became a household term during the COVID-19 Pandemic, and suddenly seemingly everyone was searching for therapists.

But those seeking therapy almost always ran into the same issue – it was incredibly hard to find a therapist that was available, a good fit, and accepted their insurance.

So, many people started looking outside their insurance network.

Compared to in-network therapy, out-of-network therapy is typically more expensive upfront. Every session with an out-of-network therapist can cost quite a bit, and patients usually don’t know how much their insurance will reimburse them.

At the same time, many therapists choose not to work with insurance. The main culprits being low reimbursement rates, high admin lift, and lack of autonomy.

So, while therapy became an essential and life-saving service, many were stuck on how to afford it.  Out-of-network therapy is just not a viable option for many people, and for those that it is, they are overwhelmed with the lengthy and manual process involved in getting their insurance to reimburse them.

Enter Thrizer.

We aren’t a fan of Superbills

I personally went to therapy for years and always hated the superbill process. I hated taking the time to go to my insurance portal, inputting the claim information, making sure I entered everything correctly, and ultimately waiting weeks to get a check in the mail.

Superbills are the go-to mechanism for therapists in supporting their private-pay clients. They are easy to generate in an EHR and allow therapists to remain completely separated from the world of insurance (understandable).

BUT they may not be the best option for clients. Here are a few reasons why I personally hated the superbill process.

Manual Claim Submission

Before I started Thrizer, I had no understanding of insurance lingo. And why would I? It was largely irrelevant to my life outside of those 5 minutes a month that I submitted the superbill.

But those 5 minutes were not fun. My insurance portal didn’t have an “upload” feature, and to submit a claim for reimbursement you had to type all the information in.

To make it worse, the fields in the insurance form didn’t match 1:1 with the superbill. The superbill used CPT codes while the insurance portal used Procedure Code. There were several fields that weren’t provided in the superbill altogether.

Though I figured it out, there was always this lingering doubt if I’d submitted the claim correctly.

And ultimately, it was effort and energy that I did not want to deal with.
 

Manual Claim Tracking

Once the claim is submitted, the stress is hardly over. There really isn’t any indication that you submitted a claim correctly, and you only find out it was correct once the check arrives in the mail (more on that below).

It the meantime, you have really no way to find out what is going on with your claim. If it is incorrect or denied, it is tough to find an answer why.

Getting on the phone to call up your insurance rarely leads to a satisfactory answer, and at the minimum it is an hour down the drain.  

Once again, it was effort and energy that really didn’t seem worth it.

Reimbursement by Check

I swear, insurances do this one on purpose.

One of the major challenges people face when dealing without-of-network therapists is the wait time to get reimbursed by insurance companies.

And part of that reason is that insurances reimburse their members via… paper check.

NO ONE should be getting paid via check anymore. They’re slow and prone to error. They can get lost in the mail. Your bank takes days to clear the funds for you to use.

If insurances pay providers and their staff via direct deposit, why can’t they do so with their paying members?

This was a central question that came up while I was building Thrizer.

And it turns out… they can.

Thrizer fixes all of this

Many people don’t submit their superbills at all because of the above reasons. The time & effort is just not worth it. Others submit them with no expectation of getting anything back – and anything they do get back is a win.

For households where finances are tight, this process just simply is not an option. One claim delay or check lost in the mail means a cessation of treatment.

Thrizer’s first goal was to fix this broken process. And it happened.

18 months in, we’ve built a platform that we’re super proud of. Automatic claim submission, real-time statuses, and reimbursements via direct deposit (like all modern payments should be).

When someone signs up for Thrizer, they link to their health plan and verify out-of-network coverage – so they know exactly how much they will owe.

When they pay with Thrizer, a (flawless) claim is generated and submitted automatically to their insurance. Any reimbursements come quickly and in the form of an electronic deposit to their preferred bank account.

And best of all, therapy-goers never need to call up their insurance again. Thrizer offer real-time claim statuses and handles all communication with insurances.  

But still, there was something missing.

There was still a gap for individuals who couldn’t afford to pay the initial upfront cost of their therapist’s fee, even if the reimbursement came to them quickly and without issue.

Enter Thrizer Pay.  

Launching Thrizer Pay

We began beta testing Thrizer Pay in late-2022 and recently announced its public launch.

It was an immediate hit. And it makes sense.

Imagine a world where starting your therapy journey didn’t need to depend on finding someone available who accepts your insurance.

Imagine a world where you only pay $30 for an out-of-network therapy appointment, despite your therapist’s fee being $200 per session.

Imagine how much more therapy you can do in a month. How much more energy you’d devote to your journey.

You wouldn’t even know the difference between “in-network”and “out-of-network”. It wouldn’t matter. For you, the net cost is the same.

But for your therapist, it makes a world of a difference. They are paid fairly. They can earn an income that helps support themselves and the training they took to get licensed. They don’t have to burn out seeing loads of clients every week just to stay above water.

This is all because of how out-of-network benefits work, and how Thrizer’s payment infrastructure leverages them in a game-changing way.  
 

How Thrizer Pay works

Thrizer Pay works pretty much the same way as the standard process did.

Therapy-goers link their health plan, understand their coverage, and start paying for therapy with Thrizer. All payments are automatically applied to their out-of-network deductible.

Once they meet their deductible, it gets interesting.

Thrizer Pay allows individuals to pay what they actually owe for therapy sessions. In other words, save upfront with their out-of-network benefits, rather than paying their provider’s full fee and waiting for reimbursement.

When doing so, Thrizer covers the rest of the provider's fee and waits for reimbursement on behalf of the patient.

Let’s use the example above. Say your provider’s fee is $200, and your insurance is covering $180 (yes, this happens all the time and is a story for another day).

Your net cost for the appointment is $20. But paying $200 and waiting for the $180 back can burden your bank account.

With Thrizer Pay, your card is only charged $20 at the time of the appointment (plus Thrizer’s 5% fee).

The remaining $180 is automatically floated by Thrizer, so the provider still receives their full $200 immediately.

Thrizer then does what we do best on the backend – get the insurance reimbursement quickly.

It is a true win-win.

By using Thrizer Pay, therapy-goers can significantly reduce upfront out-of-pocket costs for sessions, while therapists can continue to charge and earn what they are worth. 

We think this is huge

Thrizer Pay is a new way to access therapy and is rapidly changing the therapy landscape.

Mental health struggles severely impair an individual's ability to live a healthy and fulfilling life. It is a cause that is so close to my heart, after a decade-long battle with anxiety, addiction, and disordered eating.

Therapy saved my life and continues to save lives every day.

And now with Thrizer Pay, therapy can be readily accessible to everyone.

This opens a whole new world of options for anyone searching for a therapist or out-of-network provider.

No longer do they need to limit themselves to their network and compromise on how soon they receive care.

People who could have never afforded to go to out-of-network specialists before, now can.

Those who depended on insurance reimbursements to book their next session, can now increase their monthly therapy appointments by 4x, without worrying about their bank balance.

Thrizer Pay allows people to truly focus on themselves and their healing, rather than how they will afford care.

Thrizer Pay is revolutionizing the world of therapy – and we’re just getting started.

P.S. – if you’re interested in getting started with Thrizer Pay,
simply sign-up on our website!

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This blog post is provided for informational purposes only and is not intended as legal, business, medical, or insurance advice. Laws relating to health insurance and coverage are complex, and their application can vary widely depending on individual circumstances and state laws. Similarly, decisions regarding mental health care should be made with the guidance of qualified health care providers. We strongly recommend consulting with a qualified attorney or legal advisor, insurance representative, and/or medical professional to discuss your specific situation and how the laws apply to you or your situation.

About the Author
Raunak Sharma

Raunak is the Founder & CEO of Thrizer.