A superbill is a detailed invoice that a client can submit to their insurance for reimbursement if you are out of network.
What is a superbill?
A superbill is a document for insurance companies that details the services a healthcare provider performs for a client. Essentially, it's a receipt for a client's visit. However, unlike traditional receipts, superbills contain vital information, like diagnosis and procedure codes, required by insurance companies to reimburse the client for the services after they've paid. They're different from standard medical bills in that insurers use them to reimburse patients rather than pay providers.
Why is a superbill needed?
Superbills are needed for out-of-network billing. Superbills detail services received from a provider who is not within a client's insurance network. The provider may belong to a different network.
When is a superbill provided?
A superbill is typically provided to a client after they've paid for their care out-of-pocket (cash pay).
How is a superbill used?
To get a superbill reimbursed, you or your client has to file an out-of-network claim with the relevant insurer. The insurer will review the superbill and reimburse all, a portion, or none of the services outlined in the claim depending on their assessment.
Does Grow generate superbills for me?
No. Grow does not offer a superbill template or generate superbills on your behalf at this time. Various templates are widely available, including directly from some insurance companies. Please consider your particular situation when selecting or creating a superbill format. The superbill should include the information outlined in the next section.
What information is included in a superbill?
A superbill is usually one page and must contain the following:
The clinician's name.
The practice name and address.
Phone number, date, and place of service.
TAX ID.
NPI number.
State license number.
Checklist of CPT codes.
A place to write DSM or ICD diagnosis codes.
The charge for service and the payment.
Balance due.
Signature of the clinician.
Who can submit superbills?
A client, a provider, or a third-party service can submit superbills to insurers.