Therap Billing FAQs

My provider agency uses a third-party system for recording service delivery, and we plan to take advantage of Therap’s Provider Aggregator. What happens if our vendor isn’t ready to use the Provider Aggregator? (updated 4/26/24)

If a third-party vendor is not ready to use Therap’s Provider Aggregator, your agency will need to use Therap for billing to continue providing services until your vendor is ready. A firm readiness cut-off date is being developed and will be shared in future communications.

What programs are included in Therap Billing? (updated 4/25/24)

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)

What programs will NOT bill through Therap? (updated 4/25/24)

ECF CHOICES and CHOICES
Private ICF
Katie Beckett Part A
TEIS
MAPs
Tennessee Strong Families

When will billing for Therap begin? (updated 4/25/24)

All services that are provided on or after July 1, 2024, will be billed in Therap.

Will ISC agencies also be billing for ISC services in Therap? (updated 4/25/24)

Yes, ISC services will be billed in Therap.

Are daily notes required in Therap? (updated 4/25/24)

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.

Is there a section in the billing portal to keep notes if providers choose to keep their notes in the system? (updated 4/25/24)

Yes, providers can use the optional Case Notes Module to keep daily notes.

Will the aggregator for Therap be ready to import the billing data? (updated 4/25/24)

The aggregator is ready. Third-party vendors must ensure that they are ready to interface with Therap.

What support options will be available for providers and ISCs if they encounter questions or issues with Therap billing? (updated 4/25/24)

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.

Will larger agencies still have the option to bill on the cadence that meets their needs (weekly, monthly, etc.)? (updated 4/25/24)

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.

What method of data collection will be used for entering service data? (updated 4/25/24)

The three methods of data collection types DIDD will be utilizing on July 1, 2024, are Attendance, EVV, and Billing Data Input.

Once billing goes live, the Provider Authorized Service Detail Report can be found in the report library to determine what method of data collection is needed for each service.

Can providers create sites and programs now? (updated 4/25/24)

As long as the permissions (provider setup) are completed, providers can start to create sites and programs.

You can find more guidance at this page: https://help.therapservices.net/s/article/843

Will third-party vendors be given access to the aggregator? (updated 4/25/24)

Third-party vendors have already contacted Therap for access to the aggregator. New third-party vendors interested in gaining access to the aggregator can contact Therap to sign up.

Will PCP be used for any billing? (4/25/24)

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.

Will billing corrections be open anytime in Therap? (updated 4/25/24)

Yes, once Therap processes the original claim's 835 from the MCOs, providers will be able to submit corrections.

Who will our payments come from upon the change? (updated 4/25/24)

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 & 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.

Are the programs the person needs to be enrolled in for billing before the service authorizations can occur different than the sites and programs they are enrolled in within the Therap system now? (updated 4/25/24)

Individuals can stay in the same programs; for EVV services currently going through the claims matching process in Therap, individuals must stay in their same sites and programs to avoid any impact to Legacy Billing.

How will agencies receive our remittance advices? (updated 4/25/24)

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.

Will providers still receive the adjucated waiver claims reports in Excel via email? (updated 4/25/24)

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.

Will providers get denials for services that will need to be worked? (updated 4/25/24)

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.

Where can we find training recordings and presentations? (Updated 5/10/24)

They are available on Therap's TN support website under Service Providers > Billing Information.

When Therap was about to go live with EVV, we were partnered with a Therap staff for private training. Will that happen with this process? (Updated 5/10/24)

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).

In Therap, does the individual's time zone default by location? (Updated 5/10/24)

Each time zone is set up by a provider account. The provider account time zone flows down into the individual's time zone.

Do we have to enteral all of our Direct Support Professionals (DSPs) in the system? (Updated 5/10/24)

No, only those who need to document in Therap.

If we have one client in one home are they entered as a site? (Updated 5/10/24)

Yes, a home would be a site.

For each service that we provide we need to create a Program and then assign the sites and then go through the list of people supported and assign the correct programs according to their authorized services? (Updated 5/16/24)

Sites are created first > then programs > sites are attached to
programs > individuals are enrolled in programs.

Do we set up our own sites codes? (Updated 5/16/24)

Site codes are a legacy term in Titan. As mentioned above, in Therap providers set up their own sites and programs.

If we already have sites set up will these have to be recreated? (Updated 5/16/24)

Will attendance be entered by site or by program? (Updated 5/16/24)

The program and site are linked together. Attendance is entered by program, but there can be multiple programs by site.

When enrolling individuals into our Programs in Therap, is the enroll date the date they were originally enrolled into the waiver, the date our agency picked them up or the day we enroll them into the Program we've created in Therap? (Updated 5/16/24)

The day they were enrolled in the program.

How do I get my service authorizations in an exportable format similar to how we receive cost plans today? (Updated 5/16/24)

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.

Do you need to acknowledge each individual pending Service Authorization to be able to bill? (Updated 5/16/24)

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.

When will providers receive the new auths starting 7/1 to acknowledge prior to the start of billing? (Updated 5/16/24)

Service authorizations will be able to be acknowledged in mid-June. As the exact date
becomes available, we will make providers aware.

How will the authorizations be uploaded? (Updated 5/16/24)

Service authorizations will be sent directly from the DIDD oversight account to the
provider accounts. No uploading into Therap is necessary.

How will Therap communicate with our current system through the Aggregator? (Updated 5/16/24)

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.

Are all third-party vendors ready to use the Aggregator on July 1? (Updated 5/16/24)

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.

When is it necessary to enter individual staff in Therap? (Updated 5/16/24)

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.

Is service documentation the same as staff daily documentation notes? (Updated 5/16/24)

No, staff daily documentation notes may be different than the service documentation done
in Therap to generate a claim.