How Billers Work in TherapyNotes
By George Ruan • October 19, 2026
A biller in TherapyNotes prepares claims from completed visits, tracks problems after submission, and records insurance payments. The therapist still supplies the clinical documentation and makes the clinical decisions. A useful handoff makes three things clear: what is ready, what is blocked, and who needs to act next.
TherapyNotes connects several of those steps through its billing and To-Do screens. But a completed task or a smaller notification count is not always the same as a resolved claim. Here is how to keep the distinction clear.
For US therapy practices • Checked against TherapyNotes documentation October 19, 2026. Confirm your account’s settings and your biller’s agreed scope.
Sections
The first handoff: a signed note becomes a billable claim
TherapyNotes’ electronic-claim workflow starts with a completed, signed billable note and a client set up for insurance billing. The biller works from Billing → Submit Electronic Claims or the corresponding To-Do item. The initial view covers pending appointments within the last 90 days; older work needs a wider filter. That is a display setting, not a payer filing deadline. Submit Electronic Claims.
Before submission, the biller should compare the payer, member information, clinician, service date, and practice-supplied service and location details. When something conflicts, ask a specific question. “Which policy covered this service date?” is more useful than “Please fix billing.”
Red warnings block submission. Yellow warnings identify possible discrepancies that still need review, even when the information may be correct. The biller reviews claim details before sending the selected claims. TherapyNotes’ submission guide explains these controls.
If a signed visit still is not ready, use our focused guide to a completed note with a claim that is not ready. The answer may be a different missing step—not another signature.
Practice Biller is different from assigned-patient billing access
A Practice Biller can generate and track claims, enter payments, and run billing reports across the practice. That role alone does not grant clinical-note access. Use an individual login and review all assigned roles rather than assuming the billing label describes the entire account. TherapyNotes’ user-role documentation.
Biller for Assigned Patients Only is narrower: it cannot submit electronic claims or generate CMS-1500 forms or superbills. Also confirm payer connections separately. Enrollment for electronic claims or electronic remittance advice (ERA) is not network credentialing; an already-credentialed clinician may still need electronic-service enrollment. Quick Start: Billing.
For the invitation steps, see adding a biller in TherapyNotes. Routine billing work is not a reason to automatically add clinical or administrator privileges.
A reviewed rejection can still be an unresolved claim
Electronic Claim History distinguishes Submitted, meaning sent to the clearinghouse, from Sent, meaning forwarded to the payer. Neither proves payment. Its Paid status reflects an insurance payment entered and allocated in TherapyNotes. Electronic Claim History.
Mark as Reviewed does not fix the claim. It changes Rejected - New to Rejected and removes the new-rejection notification. The biller still needs to investigate the reason, make any supported correction, and track the result. TherapyNotes also warns that not every payer reports rejections through the EHR. Claim-history documentation.
For a denial or a stalled claim, a useful follow-up record says what the payer reported, what should happen next, who owns that action, and when to check again. “Reviewed” is an activity; “corrected and accepted,” “awaiting a clinician response,” or “payer inquiry pending” tells the owner what remains.
Receiving an ERA is not the end of payment posting
TherapyNotes uses assisted ERA posting. The software fills in information and suggests changes; a person reviews it and completes the posting. From Billing → ERA or To-Do → Process ERAs, the biller matches unresolved items, reviews allocations and conflicting suggestions, and selects Post Payment. Each payer needs the applicable ERA enrollment. Post ERA Payments.
The practical owner question is not just “Did the ERA arrive?” It is “Was it reviewed and posted correctly?” Then compare recorded insurance payments with actual checks or electronic funds transfers (EFTs) received. Posting is a bookkeeping step, not an instruction that causes the payer to deposit money.
Fictional example: two visits need different people
Leena’s practice has two visits waiting to bill. One needs her signature; the other needs a confirmed member number. The biller sends the clinical task to Leena and the insurance question to the office contact. After both answers arrive, the biller reviews and submits the claims. Later, an ERA contains an unmatched service. The biller checks its claim reference and service date before posting, instead of forcing it onto the nearest appointment.
What should therapists own—and ask about?
The therapist supplies accurate clinical content, completes required signatures, and confirms that the service information reflects the care provided. A biller can flag an incomplete step or relay a payer request; the therapist writes the clinical explanation. Agree on which patient communications, adjustments, or other decisions require your approval.
At your billing check-in, ask for:
Visits waiting on a clinician, insurance information, or enrollment—and the oldest date in each group.
Reviewed rejections that remain unresolved, not just newly flagged rejections.
Unpaid claims needing payer follow-up, with a next action and owner.
Remittances waiting to be posted and recorded payments not yet matched to received money.
A busy week of new submissions can coexist with older work that needs attention. Ask about both.
Shameless Bomi plug
If TherapyNotes works for your practice, you can keep it while getting human billing help. Bomi works inside TherapyNotes as a billing user. Talk with Bomi about taking billing off your plate.
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About Bomi
Founded by George Ruan, Dax Earl, and Andrey Goder, Bomi helps independent therapists and group practices with insurance billing, credentialing, and payer follow-up. Bomi grew out of Dax’s experience helping his mother with her therapy practice, with a clear purpose: reduce the administrative burden of insurance while keeping practice owners in control.
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