Therap Billing FAQs
The following programs will be using Therap for billing:
- 1915c waivers:
- Comprehensive Aggregate Cap (CAC) waiver
- Self-Determination (SD) waiver
- Statewide (SW) waiver
- Katie Beckett Part B
- Public (State Operated) ICF Homes
- State-funded services (i.e., hospital attendant)
- ECF CHOICES and CHOICES
- Private ICF
- Katie Beckett Part A
- TEIS
- MAPs
- Tennessee Strong Families
All services that are provided on or after July 1, 2024, will be billed in Therap.
Yes, ISC services will be billed in Therap.
No, it is not a requirement at this time. However, it will be part of a future implementation. Daily notes are still required outside of the system.
Yes, providers can use the optional Case Notes Module to keep daily notes.
If you use a third-party system and are interested in interfacing with Therap, reach out to tnsupport@therapservices.net
If there are questions or issues with billing in Therap, the first support option is to look at the Therap support page: https://help.therapservices.net/s/tennessee.
If providers are unable to resolve their concerns through the content on the page, please contact tnsupport@therapservices.net.
Providers can enter billing data and submit claims at any time; there is no calendar restriction as in PCP. Therap will send submitted claims to the MCOs on a weekly basis.
For a new provider or an existing provider who wants to add a new program, guidance can be found at this page: https://help.therapservices.net/s/article/843
The Department's Provider Claims Processing (PCP) System will remain active for the submission of claims with dates of service of June 30, 2024, and prior. This includes the submission of new claims, late billings, adjustments, and voids.
Yes, once Therap processes the original claim's 835 from the MCOs, providers will be able to submit corrections.
For claims with a date of service of July 1, 2024 and after, payments will come from the MCOs, except for state-funded services and Katie Beckett Part B services.
State-funded and Katie Beckett payments will remain the same as it is today. While billing for these will occur in Therap, payments will still be paid through Edison.
For claims with dates of service prior to July 1, 2024, payment will come from TennCare, on the current schedule.
For claims with a date of service of July 1, 2024, and after, remittance advices will be available in Therap.
For claims with dates of service prior to July 1, 2024, remittance advices are available through TennCare, as they are today.
These reports will continue to be sent for claims submitted in PCP with dates of service prior to July 1, 2024.
These reports will not be sent for Therap submitted claims, since providers will have access to pull claim reconciliation reports in Therap.
Yes, if a claim is denied by an MCO, it will show on the provider’s 835 report, and in Therap, with the adjustment codes and descriptions. Providers will be able to make adjustments and resubmit these claims to the MCOs.
They are available on Therap's TN support website under Service Providers > Billing Information.
Therap meets with all new providers 1-on-1 on initial account setup. All Tennessee billing training is provided via webinars or through support materials (written guides and videos).
Each time zone is set up by a provider account. The provider account time zone flows down into the individual's time zone.
No, only those who need to document in Therap.
Yes, a home would be a site.
Sites are created first > then programs > sites are attached to
programs > individuals are enrolled in programs.
Site codes are a legacy term in Titan. As mentioned above, in Therap providers set up their own sites and programs.
The program and site are linked together. Attendance is entered by program, but there can be multiple programs by site.
The day they were enrolled in the program.
In Therap, a provider will be able to view all their Approved service line items
(SLIs) in the Service Authorization module, and this information can be
exported to Excel. This will be the replacement of the legacy system cost
plans. The Service Auths are available to export at any time and will be
updated in real-time, as new services are approved or amended.
Each authorization is for a date range, so users will only need to acknowledge an
authorization once unless there are changes made to this throughout the plan
year/ timeframe.
Service authorizations will be able to be acknowledged in mid-June. As the exact date
becomes available, we will make providers aware.
Service authorizations will be sent directly from the DIDD oversight account to the
provider accounts. No uploading into Therap is necessary.
Therap is setting up a data exchange with other vendors for non-EVV service
documentation. Providers will still need to acknowledge pre-authorizations,
generate claims or correct billing in Therap.
All known third-party vendors have completed the steps to interface with Therap on July 1. Providers should work with their third-party vendors to confirm they have gone through the appropriate steps to interface with Therap.
Staff are required if they are providing EVV. For other services, each provider may choose whether each staff enters service data at the time of service delivery, or if this is done centrally.
Therefore, it is up to the provider.
No, staff daily documentation notes may be different than the service documentation done
in Therap to generate a claim.
Providers who currently receive Waiver and State ACRs by email will continue to receive them if the Provider enters adjustments, voids, and late bills in PCP for DOS on or before 6/30/2024 and are processed by TennCare.
On 7/01/2024 and forward, Providers will access Therap and can run a Reconciliation report to view the status of their claims from the MCOs.
Link to guidance here