Instructions for using the Check Eligibility feature inside Therasoft

Instructions for using the Check Eligibility feature inside Therasoft

Steps
  1. Login into Therasoft
  1. Navigate to the client insurance page

    1. From the top menu:
      Insurance -> View Clients -> Select client from list
    2. Enter the insurance details (if not already added) in the INSURANCE INFORMATION section
  2. Run Inquiry
    1. Click on Check Eligibility button
    2. The system will return a list of benefit categories, often grouped by service types
  3. Prioritize Mental Health-Related Categories
    In the returned benefit summary,     click on the service categories to unfold & show the benefit details:
    1. Mental Health
      This should be the first benefit block to be checked. Many payers use this service type.
      Example:
  1. Mental Health Provider - Outpatient
    Check this benefit block if no relevant details are found in the above one.
  2. Some payers use this service type.
    Example:
  1. Professional (Physician) Visit - Office
    Check this benefit block if no relevant details are found in the above one.
  2. Most of the payers use this service type.
    Example:
  1. Professional (Physician)
    Check this benefit block if no relevant details are found in the above one.
  2. Some payers use this service type.
    Example:
  1. Health Benefit Plan Coverage
    Check this benefit block if no relevant details are found in any of the above ones.
    Example:


  1. Locate Cost Share Details
    Within each benefit block, look for:
    1. Co-Payment
    2. Co-insurance
    3. Deductible
    4. Place of Service (if present, look for Office)
    5. Payer Note (if present, look for note similar to Specialist office visit)

Example:

  1. Note Individual vs Family Coverage
    1. Most plans show both Individual and Family coverage
    2. Use the Individual benefits unless you know you’re billing for a dependent under a family plan


Notes
Please Note:
Most payers do not require enrollment.  The payers that do require enrollment are listed on the attachment below. 
If enrollment is required, please submit a support ticket.