Superbills list services provided, diagnosis codes (ICD-10), procedure codes (CPT), and provider information. They are highly utilized for out-of-network or cash-based therapy and chiropractic practices.
Patients submit these superbills directly to their payer to request reimbursement based on their out-of-network benefits. Accuracy is critical. Even a small error in the provider's NPI or a code mismatch can cause the payer to reject the patient's request.
Why it matters
Incorrect superbills create frustration for patients and additional follow-up work for staff. A clean superbill process is essential for patient satisfaction in cash-based clinics.
Pro Tip
Standardizing and automating superbills helps reduce errors and ensures patients can submit their superbill quickly and accurately.
FAQ
Do all clinics use superbills?
No. They are primarily used in out-of-network or cash-pay models where the clinic does not file the claim directly.
Is a superbill the same as an invoice?
No. An invoice simply requests payment from a patient to a provider. A superbill includes clinical coding and treatment specifics required for insurance processing.
Can Medicare patients use a superbill?
Generally, no. Physical therapists have specific mandatory claim submission requirements for Medicare beneficiaries even if listed as “non participating providers (out of network)”