Therabill performs many error checks when you create an insurance claim. One of those error checks is a verification that the service codes you are using are valid CPT codes. Therabill will stop you from submitting the claim (when billing to insurance) if the service code you are using is not a valid CPT code. However, you may be submitting to an payer that uses service codes that are not in the CPT database published by the American Medical Association. Therabill will allow you to add rules to let Therabill know that certain service codes are valid for a specific payer. Warning: By doing this, you will be by-passing the CPT code validity check when submitting your claims.
Adding Service Codes for an Insurance Company.
Adding a rule to let Therabill know that service codes (that are not CPT) are valid for a specific payer is done through the insurance company settings.
- Click Billing in the top navigation bar of Therabill.
- Click Insurance List in the sub-navigation bar of Therabill.
By entering a service code in the insurance company settings, you will be by-passing Therabill's built in CPT code validity error check (for this code) when you are creating your claims for this insurance company. Please make sure you are entering a service code that the insurance company you are submitting to does consider valid. Otherwise, it may be rejected by the insurance company.
When submitting electronically, your claims go through error checks at different places (other than Therabill) on their way to the insurance company. Most of these error checks are going to check for validity of the CPT code. If submitting electronically, your claim may still get rejected somewhere upstream. If this happens, you may need to submit by paper to get non-CPT service codes to the payer.