Treatment Paused

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Treatment pauses help prevent the client from racking up a bill, which causes more financial hardship.  They are called "pauses" because, ultimately, we would like the client to stay as a client and continue getting the support they need.  Clinicians can help clients avoid treatment pauses by reminding them (or walking them through the process) to pay their copay during the sessions.  This is especially true for telehealth sessions and sessions with minors.  Get the parent involved to avoid the treatment pauses.  The parent can put a card on file in the Client Portal so they don't have to be present at every session to pay the copay.

When does the Billing team initiate the Treatment Pause

The Billing team will notify clients via TN Messaging that we are "pausing" treatment due to billing issues.  The reason for the client being put on a treatment pause is any of the following:

  • Medicaid coverage terminated OR
  • Commercial insurance coverage was terminated, and a large outstanding balance OR
  • Large outstanding balance, usually around $200+ OR
  • The outstanding balance is $20+ and 14+ days old.

If this happens, the Billing team will:

  1. Cancel all future sessions.
  2. Put a cancellation note on the canceled session explaining the reason for the pause in treatment.
  3. Put the label “Treatment Paused” in the preferred name field.
  1. Send the client a message in TN messages explaining the reason that was sent to the client.  
  2. Upload a Billing Statement to the Client Portal.

To prevent this issue, a brief reminder during EACH session encouraging your client to pay their copay/fee via the Client Portal can be highly effective!

The message sent to the Client via TN Messaging

Clinicians can look at TN Messaging to see the communication from/to the billing team.

Hi Jane Doe,

Regrettably, we must temporarily pause treatment and cancel all upcoming sessions until you reply with one of the options below. This measure is taken to prevent further financial complications.  Please review the uploaded Outstanding Balance statement in the Documents tab and if you’d like to pay your balance, click on the Billing tab. There, you have the option to pay the full amount or enter a partial payment.

Please REPLY and let us know how you would like to proceed:

  1. I will pay the balance (in full or via payments) and then reschedule with my provider within the next ~30 days.
  2. I will work to reinstate my insurance/Medicaid with a retroactive effective date that covers the outstanding sessions.
  3. I will work to reinstate my insurance/Medicaid with a future effective date AND make a partial payment AND reply with a payment plan details of my choosing and then resume services immediately.  
  4. I will find new insurance, AND make a partial payment, AND reply with a payment plan details of my choosing and then resume services immediately.  
  5. I will sign the private pay agreement, AND make a partial payment, AND reply with a payment plan details of my choosing and then resume services immediately.  
  6. Terminate treatment

*** Please note that if you don’t follow through with the payment plan details you created, we will have to pause treatment again.

Please reply here and let us know how you’d like to proceed.  

When can the clinician restart treatment with the client?

The clinician can restart treatment once the billing team gives them the go-ahead OR the treatment paused label is removed. You may contact the Billing Team via email or chat to verify if a client has made a recent payment.  The following steps will take place when a treatment pause is lifted:

  1. The “Treatment Paused” tag will be removed from the client's name.
  1. The client will be notified (via TN Messages) that they can schedule an appointment and/or their upcoming appointment will be reinstated.  

What if the client doesn’t respond, fails to obtain new insurance or doesn't pay?

  • Pro Bono Policy outlines some Pro Bono options that can be offered to the client.  
  • Suppose there's been no activity in TN for 30 days. In that case, TN should give you a Todo to terminate with the client and at that time, you will follow typical termination procedures:  Termination Note Expectations & Procedure.

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