What is a Superbill in Medical Billing and How to Submit it to Insurance

A Superbill in medical billing refers to a list of services given to the patient, including the information about the patient's visits, CPT, and ICD codes. Healthcare providers use superbills when filing claims to get payment against services.

Still confused regarding the superbills? This blog will explore useful information about super billing, including its purpose and components.

What is a Superbill for Therapy

A Superbill for therapy, also called a therapy superbill, is a receipt of services given by a therapist to the patients. Often, the clients use a superbill when they don't have insurance for treatment or their provider is operating out of network.

If you are wondering what a superbill should include, it must have a number of services, the patient's diagnosis, and the payable amount.

What are the Components of a Superbill

As we have studied above, a superbill has important information from 3 dedicated areas, including provider, patient, and visit information.

1) Provider Information

This section covers the data related to practice and the healthcare provider. Specifically, the provider information section has the first and last name, the unique 10-digit National Provider Number (NPI), phone number, and email address of the provider and office location of the patient`s visit.

2) Patient Information

As the name suggests, this area includes information about the patient's first and last name, date of birth, phone number, address, and insurance information.

3) List of All Expenses

Providers should mention all the expenses next to their respective date and codes. The total balance must indicate the amount against all the services rendered.

4) Visit Information

This is the most detailed informational area of a super bill that a provider uses for reimbursement. Therefore, the visit information area must include the date of the application, the fee, and the medical codes explaining the particular disease and procedure. These codes include both CPD and ICT.

• CPT Codes: Current procedural codes are 5-digit numerics for tracking and billing the services, such as surgical and diagnostic. The AMA (American Medical Association) develops the codes and updates them accordingly.
• ICT Codes: ICD-10 codes in the superbill are 7-digit numerics that classify patient injuries and medical procedures. These codes also indicate what part of the body requires treatment.

Who Issues Superbills?

A superbill is a document with information about services given to the patient, which he submits to the payers. Who issues these superbills, then? Any healthcare provider involved in treating a patient can issue a super bill, These include:

• Dietitian
• Therapists
• Chiropracter
• Pharmacists
• Speech language pathologists

Usually, a mental health expert issues superbills after a month. However, you can request them to give you one within 30 days.

How to Submit a Superbill to Insurance

How does a superbill work for insurance? There is no rocket science to submitting a superbill but it is a simple process. A superbill for insurance contains out-of-pocket expenses against the healthcare services, meaning the provider was not contracted with your insurance company.

• Gather Necessary Understanding
  Before submitting your superbill to the provider, it is essential to understand everything about superbill insurance, superbill template, etc. In addition, you must view the plan details on the insurer's website for a better understanding.
• Additional points you must know about
  Below are some key aspects of the superbill that you should understand. Knowing these will help you save more money on the healthcare services you receive.
  1. Out-of-network benefits
  2. Understanding about deductible
  3. What is covered under your insurance plan
  4. Total percentage of healthcare services covered under your insurance plan
• Cross-Check Your Information
  When submitting a claim against the superbill, check the information to avoid claim rejection. Insurance providers often reject claims with missing data such as insurance ID numbers.
• Review all the Codes CPT/ICD
  It is recommended that patients ask an expert to submit claims on their behalf. However, if you are doing it yourself, make sure the codes are properly assigned.
• Preparation for refiling the claim
  Once you have verified all the details and submitted the claim, you can relax as reimbursement is on the way. Sometimes, the providers reject claims based on slight mistakes. Therefore, do all the preparation to refile it after the rejection.

The superbill for out-of-network charges covers full and partial payments. In other words, every insurance plan differs from each other. Therefore, the provider must call the provider and ask about the coverage details.

How Does a Superbill Work?

If you are searching on the internet about how a superbill works? Here is the answer. A healthcare provider examines the patient's health and the required services. After the treatment is done, the patient has to pay the expenses out of his pocket.

If the patient has out-of-network benefits, he can submit the bill to the insurance provider to claim the payment back. However, the insurance coverage percentage depends on the provider's policies.

Every payer offers different plans, insurance limits, and deductions to the patients. Therefore, it is recommended that a patient gather necessary information about their payer before getting healthcare treatments.

Tips for Creating a Superbill for Mental Health

Creating a superbill for mental health may seem like a challenging task when patients do it themselves. Here are the steps one needs to follow

Share bills in the form of PDF: Providing a superbill template for mental health in the form of PDF is highly recommended. A PDF reduces the chances of making unwanted edits, which can result in fraud.

Make your clients submit superbill regularly: Many clients submit their superbills on the month-end. However, regular submission makes it easy for the providers to audit and highlight the mistakes.

Educate clients about getting a superbill: Some patients remain unaware of getting reimbursements using a superbill. Therefore, educate them about its benefits and ask them to get bills after the treatment.

Conclusion

A superbill is very important for the patient to get reimbursement against the out-of-pocket expenses. When a provider is out-of-network, then the patient has to pay the treatment expenses. The healthcare provider issues a superbill to the patient, he files for a claim, and gets his payment back from the insurance company or payer.

However, it requires proper details such as the patient's name, address, and the number of visits. Moreover, he must assign accurate codes, or the claim can be rejected. Therefore,the patient must ask a professional expert to file a claim on his behalf, ensuring quick payments.

1) What is a superbill?
A superbill is a detailed receipt listing medical services, diagnoses, and procedure codes. Patients use it to submit to insurance for possible reimbursement.

2) When do you need a superbill?
You need a superbill when you pay out-of-pocket for care, especially with out-of-network providers, and want insurance to reimburse part of your cost.

3) What information does a superbill include?
It includes patient details, provider information, date of service, diagnosis codes (ICD-10), procedure codes (CPT), service fees, and sometimes the provider’s signature.

4) How do you use a superbill for insurance reimbursement?
After your visit, get the superbill, complete your insurer’s claim form, submit both, and the insurance company may pay back part of your healthcare costs.

5) Is a superbill the same as a bill or invoice?
No. A superbill is not a request for payment. Invoices ask patients to pay, while superbills help patients claim reimbursement from insurance.