What is a Superbill and How Do You Use It?

If you’re seeing an out-of-network provider, you may have heard the term superbill before. But what exactly is it, and how do you use one to seek reimbursement from your insurance? Here’s what you need to know.

If you’re seeing an out-of-network provider, you may have heard the term superbill before. But what exactly is it, and how do you use one to seek reimbursement from your insurance? Here’s what you need to know.

What is a superbill?
A superbill is a detailed receipt that contains all the necessary information for you to submit a claim to your insurance for out-of-network services. While the format may vary by provider, every superbill includes the following key details:

• Patient and Provider Information: The superbill will list the patient’s name, date of birth, address, and phone number, along with the provider’s name, practice details, office location, and National Provider Identifier (NPI) number.
• Dates and Costs of Services: Each superbill includes the date(s) of service and the corresponding charges. Some superbills may list multiple appointments, while others are generated for individual visits.
• Diagnosis and Procedure Codes: Insurance companies use standard codes to process claims:
  • Diagnosis Codes (ICD-10): These codes classify symptoms or conditions related to the services received.
  • Procedure Codes (CPT): These describe the specific services provided, such as an initial therapy session (60 minutes) or an individual psychotherapy session (45 minutes).

How to submit a superbill to your insurance

If we are an out-of-network provider for your plan, you will need to submit your superbill to your insurance company to request reimbursement. The process typically includes the following steps:

1. Check your out-of-network benefits. Call your insurance company (using the number on the back of your insurance card) to ask about your out-of-network coverage. Helpful questions to ask include:

• Do I have out-of-network benefits?
• What percentage of my session cost will be reimbursed?
• What is my out-of-network deductible, and have I met it?
• Are there any exclusions for mental health services?

1. Complete a claim form. Many insurance companies require a claim form to be submitted with your superbill. You can usually find this on your insurer’s website or by calling customer service.
2. Submit your claim. Submission methods vary by insurance provider. Some allow online claim submissions, while others may require fax or mail. Be sure to follow their specific instructions to avoid delays.
3. Follow up on your claim. Keep a copy of everything you submit and check with your insurance company if you don’t receive a response within their processing timeframe. If your claim is denied due to missing information, you can correct and resubmit it.

Important things to remember

• Superbills are not bills – They are detailed receipts used to request insurance reimbursement after payment is made.
• Out-of-network reimbursement is not guaranteed – Each insurance plan has different coverage levels, so check your benefits before assuming you’ll be reimbursed.
• Keep track of your claims – If your claim is denied, you can often appeal or resubmit with corrections.

If you need a superbill for your sessions at Your Choice Mental Health Therapy, please let us know, and we will provide one for you. If you have questions about submitting it to your insurance, we recommend reaching out to your insurance provider for specific guidance on their process.

If you have any question about your superbly, please give us a call.