What is a Superbill?
A superbill, also known as a courtesy bill, is a detailed invoice that a clinician can put together, which states what services a client received. It is also known as a Statement for Insurance Reimbursement. A superbill can be done when the therapist is not on the client’s insurance panel. It is a document that clinicians can give to their clients to be reimbursed by insurance payers. Typically, a clinician will have the client pay the session fee and then gives the client the superbill, or directly send it to the insurance payers.
This document is very similar to a statement, but it provides additional information such as CPT codes and primary diagnosis codes. A superbill allows the insurance payers to pay the client, not the therapist, even if the clinician is the one submitting the superbill. There are several things that are included in a superbill:
Identifying information: name, date of birth, address, phone number, insurance information
Practice information: Name of the practice and office address as well as other identifying information the insurance payer routinely requests
Referrer identification: National Provider Identification (NPI) number, if a medical provider referred you to this clinician
ICD Codes: Most insurance payers will not pay for treatment without a diagnosis and some will only cover specific treatments for specific diagnoses. Make sure you discuss the specific diagnosis with the clinician before a superbill is submitted. It can be difficult seeing the diagnosis. Make sure to have that open conversation.
CPT Codes: The Current Procedural Terminology (CPT) code uses a list of American Medical Association codes to identify treatment procedures. All relevant CPT codes are listed and reimbursement rates can be based on the specific codes.
Accepting insurance can be a challenging process, so this allows you to receive treatment from the clinician of your choice and gives you the possibility of reimbursement through your insurance payer. Superbilling offers a great option, it allows clients to pay for therapy with their insurance but without requiring the therapist to jump through the many hoops provider panels require. Hope this was helpful!
