WHAT IS A SUPERBILL?
A superbill is a form used by medical practitioners and clinicians that can be completed and submitted to an insurance company or employer for reimbursement. Nowadays, many professionals do not work directly with insurance companies. That is, they do not sign up to be a part of a medical panel or part of an insurance panel; they work as independent consultants. As such, a need arose to provide patients and clients with a document that could be submitted to insurance companies that would allow clients to be reimbursed by their insurers. A superbill can be prepared for you at the time of an office visit, or if you see your medical practitioner frequently, it can be prepared for you weekly or monthly. The superbill should contain the following elements:
- Your name
- Your address and phone
- Your birthday
- Your doctor's name
- Your doctor's address
- Your doctor's license number, NPI number, tax ID number
- Your diagnosis
- The service rendered to you
- The cost of the treatment
- The amount you paid
- A release authorization statement
- Your signature
- Your doctor's signature
Once you receive your superbill, check it for accuracy (make sure the dates/times of your visit and the amounts you paid are correct). Then simply submit the document to your insurance company for reimbursement. Your insurance company MAY reimburse you depending on the level of coverage you have. Prior to starting work with a clinician who uses superbills, you should contact your insurance company and say, "I want to work with an out-of-network provider, how much will you reimburse me?" The only way to know for sure what your insurance company will pay is to ask them directly, or better yet, get it in writing via fax or email.
Be aware that should you choose to submit a superbill, you are releasing medical information that is protected by law. This means you are waiving some of your rights to provacy and confidentiality. Your insurance company will have and keep a record of your diagnosis as part of your permanent medical file. These files can be used by insurance companies to set your rates and to allow or disallow further treatment.
SUBMITTING A SUPERBILL TO YOUR INSURANCE COMPANY DOES NOT GUARANTEE REIMBURSEMENT OR PAYMENT FROM YOUR INSURANCE COMPANY. PLEASE CONTACT YOUR INSURANCE COMPANY DIRECTLY FOR MORE INFORMATION. ALL INSURANCE TRANSACTIONS WILL BE BETWEEN YOU AND YOUR INSURANCE COMPANY.