Doctors and other staff working in a hospital or clinic need to understand the different medical billing terminology and jargon. A medical billing term that doctors and other medical practitioners must know about and understand is superbill. What is a superbill and what is it used for? Let’s take a look.
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Used to create healthcare claims, superbill is submitted to insurance companies at a later date for reimbursement. Much more than just a standard invoice or a receipt that doctor and other medical staff come across on regular basis, a superbill provides specific information to insurance companies that the latter uses to process requests for reimbursement.
Created specifically from the office of a doctor, the superbill contains the information of the patient such as the most common diagnosis and codes of procedures used by the office. The office of the doctor that provides the superbill is referred to as the provider. An important medical billing document, the superbill should contain:
- The name and credentials of the provider
- The address of the doctor’s office
- The date (s) of service
- The name of the patient
- The patient’s DOB
- The federal Tax ID number of the provider
- The treatment (s) rendered to the patient
- The cost of the treatment
- The amount paid by the patient
- The codes of diagnosis
- The CPT code (s)
- The signature of the provider
There you have—a brief overview of the superbill.
A form used by doctors and other medical staff who have no direct working relationship with insurance companies, a superbill helps patients to get reimbursed for what they paid to the doctor/hospital/clinic. Once a request has been made and a payment has been received, a superbill will be prepared for each appointment.
As mentioned above, a superbill contains a number of things pertaining to the patient and the provider including names, addresses, Tax ID number, codes of diagnosis and procedures, and the amount paid for services. Hopefully, now you know what is a superbill. With that done, it’s time to turn out attention to how to request for a superbill and submit it to insurance.
Requesting for a superbill
In case you require a superbill to submit to your insurance company for reimbursement, following is how you should request the doctor’s office for it:
- Make the request for the superbill to the front desk staff of the doctor’s office
- After you’ve made the request, the front desk will ask you to fill out and submit the superbill request form
- Generally, the processing time for a superbill request is between 24 and 48 hours
- Inform the office of the doctors how you’d like to receive the superbill i.e. by post mail, by email or in person
The aforementioned information clearly indicates that making a request for a superbill is rather easy. The hard part is probably creating it which is of course the doctor’s responsibility. If you are a doctor or part of the medical staff then an easy way for you to create a superbill is using a superbill template. Talking about templates, you can find templates of many medical forms online including a Blood Pressure Log.
Coming back to the subject at hand, after you’ve requested for and received the superbill, the next step in the process would be submitting the bill to your insurance company for reimbursement. How can you do that? Let’s find out.
Submitting superbill to insurance company
It is important for patients to include the following things in their claim submission to the insurance company if they want to expedite their claim and maximize their reimbursement:
- A superbill of services provided at the doctor’s office
- A patient claim form provided by the insurance company
- A copy of insurance card including the patient’s member of subscriber identification number
Now that we’ve taken a brief look at the things related to a superbill, it’s time to discuss superbill and its constituents in a bit more detail.
What is a superbill: a detailed look at things
A receipt of the services provided to a patient, the superbill is submitted to insurance companies to get reimbursed for the treatments. At times, doctors submit the superbill on behalf of their patients. The important things to notice here is that doctors collect a payment from the patient even when a superbill is used for reimbursement purposes.
Unlike the traditional medical receipts, superbills require specific information such as the type of the services provided, the CPT codes, the Tax numbers etc. Though the format of the document may vary, following is the information generally included in the bill:
This part of the superbill contains the basic information about the patient and the provider. Basic information includes information such as name, DOB, address, phone number and office address.
The part of the superbill reveals information related to the provider. Provider information includes information such as the name of the provider, Tax ID number, NPI etc.
Short for the International Statistical Classification of Diseases and Related Health Problems, ICD-10 is a list of every health problem that a person can possibly develop. As they are likely to be rejected for being outdated, ICD-9 codes must not be used for superbill purposes. Instead, the document should include ICD-10 code.
An index of medical and health services, The Current Procedural Terminology, or CPT code is a creation of the American Medical Association. It is important for doctors and other medical practitioners to ensure that the codes of the services they’ve provided to their patients are included in the superbill. This is important because insurance companies reimburse based on the codes listed on the superbill.
There you have it—some of the essential things included in a superbill. In addition to the aforementioned things, a document may have a section for follow-up appointments and space for the signature of the patient. Contrary to popular belief, the benefits of a superbill aren’t just for patients. Instead, doctors/providers can also benefit from the superbill. The superbill makes billing easy for providers and allows them to keep track of each patient’s visit.
While a superbill is beneficial to both the patient and the provider, it may cause issues if it isn’t created properly. For most people, entering codes into the system is hard work. For this reason, errors occur when you list codes on a document. To make the task of manually listing codes easy and limit the chances of errors, use a superbill template.
Now that we’ve taken a good look at the things include in a superbill, it’s time to discuss in detail when a superbill should be requested and how to submit for insurance.
When to request for a superbill
One thing that many people want to know is when to request for a superbill. The simple answer to this is that the frequency of requesting for a superbill depends on your personal preference. However, following are some of the strategies employed by patients for applying for reimbursement:
- After every visit: Basically, patients using this strategy request the superbill after every scheduled appointment. When such a strategy is used, the superbill contains only a single date of service
- At regular intervals: Patients using this strategy request the superbill based on specified timeframe. When such a strategy is used, the superbill contains all dates of service since the patient’s last request
- At the end of treatment: Patients using this strategy request the superbill at the last scheduled visit. When such a strategy is used, the superbill contains every date of service throughout the patient’s care of service
Now that it’s clear how often a patient should request for a superbill, it’s time to move on to how to submit a superbill to an insurance company.
How to submit the superbill to the insurance company
It is recommended that patients call their insurance company before submitting the superbill to inform the latter that they are going to send a claim which they want verified. Following is how patients need to submit the superbill to the insurance company:
- Before submitting the superbill, review it thoroughly and ask the insurance company whether they require any additional information. Once you’ve done that, complete, sign and attach the superbill to the claim form. Also, it is recommended that you submit a copy of your insurance card in addition to the claim form and superbill
- Confirm the mailing address and ask the insurance company how long it’ll take for your claim to be paid
- Send out the claim form to the insurance company once everything is in order. It is important that the address to send the form is mentioned on the claim form itself
- For your records, keep a copy of the superbill or any other document you submit. For each mailed in claim, ensure that you receive a response. Typically, it takes two to six weeks to receive a response
- Call the insurance company to ensure that they have received the claim form and the superbill if you don’t receive a response from them by the expected date of response. After making the call, ask the insurance company when you can expect a response. If you want your claim to be processed then this step is extremely important
Why providing superbills to patients is important
Often referred to as charge slips or encounter forms, superbills are used by patients to get insurance benefits. One of the biggest favors that a provider can do for their patients is providing them a superbill. By providing a superbill to their patients, doctors and other medical practitioners can ensure that the patients are covered for their treatments. A superbill comes in handy even when the provider is considered out-of-network by providers or isn’t credentialed by insurance.
In short, a superbill can help patients to reduce their cost of health care. Preparing of it takes no more than a couple of minutes.
Today, physicians in America and around the world are using superbills to make health care affordable for their patients. An extremely important medical billing document, the superbill is submitted by patients to insurance companies for reimbursement purposes.
A document completed by the healthcare provider, a superbill includes the basic information of the patient and the provider as well as the codes of the diagnosis and the procedures. One of the most important documents for patients, a superbill is easy to create. A good and easy way to create it is using a superbill template. By looking at the template, you’ll know exactly what’s included in a superbill. This in turn will make it easy for you to create an error free experience.