How To: Manage Client Billing Settings

In TherapyNotes, a client's chart contains all of the client's records and files, giving you easy access to the information you need, whenever you need it. Each chart features a Billing Settings tab, which includes information about the client's insurance, pre-authorizations, custom rates, and more.

Role Required: Practice Biller or Biller for Assigned Patients Only

To view and edit a client's billing settings:

  • Click Patients > Patient Name > Billing Settings tab
  • Click on any of the available boxes including Billing Comments, Insurance, etc. to edit the corresponding information 
  • Once all desired changes have been made, click the Save Changes button

Billing Comments

Enter client-specific billing information in this field, such as the start and end dates of old insurance plans, coinsurance information, and other general billing comments.


To enter insurance information for the client:

  • Select the Patient Has Insurance checkbox
  • Enter the client's relevant insurance information pre-authorizations, and additional claim information, ensuring that it exactly matches the information on their insurance card

Primary Insurance


(A) Payer: Select the client's insurance provider from the dropdown. To select a payer that is not included in the list, first add the payer to TherapyNotes.

(B) Signature: Select the Patient/guardian authorized release of information and benefits assignment for claims checkbox. Insurance claims indicate that you have your client's signature on file. This signifies that the client has provided consent for billing to their insurance company to pay for the service.

(C) Copay: A client's copay dictates the Patient Amount, or the amount the client is responsible for paying, for each billing transaction. If copay is unknown, this field can be left blank, and the Patient Amount can be entered individually per transaction.

(D) Deductible: This field is for your reference only. Because TherapyNotes cannot know if the client is meeting their deductible with other providers, the system cannot automatically track the deductible amount per billing line item. For more information, read How To: Manage Client Deductibles.

(E) Appointments: If the number of allowed appointments for the client's insurance plan is known, select Number from the dropdown and enter the number of allowed appointments and the expiration date. If unlimited appointments are allowed, select Unlimited. Otherwise, select Unknown.

(F) Payments Sent To: This field designates whether payments from out-of-network insurance are sent to the client or to the practice. By default, payments are assigned according to your practice's Out-of-Network Payment Assignments selection in Practice Billing settings. Select a different option from this dropdown to override the default. If the client pays in-full up-front, assign payments to the client. If the client only pays a copay or other responsibility, assign the payments to the practice. 

Secondary Insurance

If the client has secondary insurance, select the Secondary Insurance checkbox. Enter the relevant information for the client's secondary insurance.



Click the Add Pre-Authorization button to enter pre-authorizations per service code.

The pre-authorization code is only applied to appointments that are scheduled with the same service code that is selected from the Service Code dropdown. If your practice uses two versions of the same service code, TherapyNotes will only apply the pre-authorization code to appointments scheduled with exact service code designated here.

For more information, read How To: Add Pre-Authorization Codes.

Additional Claim Information


If there is additional claim information for the client related to referrals or illness, select the Additional Claim Information checkbox.

In behavioral health, these fields are typically unnecessary and left blank. If you are required to include referral or illness information on claims, fill out the relevant information as completely and accurately as possible.

Note: If the NPI field for Referring Provider is left blank, the referral information will not be included on claims. This may lead to claim rejections.

Saved Credit / Debit Cards

If credit card processing is enabled for your practice, click the Enter Card button or the Swipe Card button to securely enter and store credit, debit, or HSA card information. Cards may also be entered when entering a client payment.

Responsible Party for Billing

If someone other than the client is responsible for the client's outstanding balances, select the appropriate contact for the client from the Responsible Party dropdown. The responsible party must first be added as a contact in the Patient Info tab.

Patient Cash Rates


If you have negotiated a custom cash rate for a client and the rate has been documented in their services contract, click the Add Rate Info button to enter the client's cash rate per service code. These rates are applied only to billing line items with the method Direct; custom rates are not applied to billing items that are sent to insurance.

For more information, read How To: Enter Custom Cash Rates per Client.

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