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What is a superbill?
A superbill is a form used by medical practitioners and clinicians that can be quickly completed and submitted to an insurance company or employer for reimbursement. Nowadays, many professionals do not work directly with insurance companies. That is, they are 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
- Any additional indetifying information (like your social security number)
- Your doctor's name
- Your doctor's address
- Your doctor's license number, NPI number, tax ID number
- Your diagnosis
- The treatment(s) rendered to you
- The cost of the treatment
- The amount you paid
- A release authorization statement
- Your signature
- Your doctor's signature
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No, the superbill is a financial document. CMS specifically states, "Superbills (i.e. encounter forms) are not a part of the medical record.
The way a superbill is processed depends on what type of insurance the patient has. For example, if a patient has Medicare or Medicaid, the claim is billed electronicall…y via a computer software that is sometimes referred to as a claims clearinghouse. There are many other insurances that require that all charges be submitted electronically. If you are billing an insurance company that accepts paper claims, you simply ensure that the claim is completed correctly and mail it to the claims address that is specified by the insurance company. If you are billing a secondary insurance payor, you have to make sure that a copy of the remittance that shows how much the primary insurance paid is attached.