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)”