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What is a superbill?

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2009-06-17 05:14:16
2009-06-17 05:14:16

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 Once you receive your superbill, check it for accuracy (make sure the dates/times of your visit and the amounts you paid are correct). Then simply submit the document to your insurance company for reimbursement. Your insurance company MAY reimburse you depending on the level of coverage you have. Prior to starting work with a clinician who uses superbills, you should contact your insurance company and say, "I want to work with an out-of-network provider, how much will you reimburse me?" The only way to know for sure what your insurance company will pay is to ask them directly, or better yet, get it in writing via fax or email. Be aware that should you choose to submit a superbill, you are releasing medical information that is protected by law. This means you are waiving some of your rights to provacy and confidentiality. Your insurance company will have and keep a record of your diagnosis as part of your permanent medical file. These files can be used by insurance companies to set your rates and to allow or disallow further treatment.

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Related Questions


A SuperBill is the charge sheet used by the provider to select the procedures and diagnosis codes that apply to the patient's appointment.

No, the superbill is a financial document. CMS specifically states, "Superbills (i.e. encounter forms) are not a part of the medical record.

An encounter form also known as a charge slip, multipurpose billing form, patient service slip, routing form, superbill, or transaction slip.

EST PT stands for established patient. US medical billing standards have different rules and pay rates for new versus established patients, so this acronym is particularly common on the "superbill," or detailed receipt of medical services.

Superbill is another term used. The most important thing to remember about pre-printed ICD-9 and CPT codes is these codes change annually so it is important to review the form to ensure all codes are current.

A superbill is a form created by an office or by providers(s) with the patient's information they are seeing, the most common CPT/ICD and HCPCS codes used by their office, and an update section for items such as follow up appointments, copays due or paid and the provider's signature. This is used by medical practitioners and clinicians so they can quickly complete and submit the procedure(s) and diagnosis(s) to a billing person or department or to an employer for reimbursement and track each patient's visit.

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 electronically 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.

Counterfeiting has been around as long as there has been currency. In older days when gold was a standard, people would treat lead coins to appear as gold. For every currency there's a different answer. More recently (1980's through 1990's) there was an attack on American currency. The story is as follows -- note that for obvious reasons, some of the details are missing. The AMerican $100 and $50 bills were duped. This apparently happened on a full scale money printing press with intaglio capabilities. The counterfeits were nearly impossible to distinguish from the originals which, reportedly, led to the new design on the $100, $50, $20, $10, and $5 bills. However, even with the new and extensive security measures incorporated into those bills, it seems another "superbill" may have emerged. While no country has been officially accused, sanctions against North Korea have been enacted by the US and Japan. At this time, some sources estimate that 1 in 10,000 bills may be a superbill. So -- in direct answer to your question -- start with getting the money together to buy the presses and cut the dies -- and of course rent or buy the facilitiy where you'll do the printing. So -- start with at least $125 million, which likely isn;t enough money for your distribution network (what do you DO with 50,000 $5 bills? A whole lot of lotto? :} ). I can go on, but you get the point. You'll need special paper that one can't buy, so you'll have to have it made - -which was hard even in the old days. Inserting the security strips, watermark and refractive indexing on the various denomination numbers requires a series of complex, expensive processes, not all of which are well-described by the Dept. of the Treasury. Even creating the dies and then recreating them when they wear out is wildly expensive and time consuming. If you're funded as stated above, and perhaps a little more, and if you find the right artisans, in a few years you should be ready to print your first bill. Just about the time they change the money again :} In this day and age, printing passable counterfeit money is way beyond the scope of the individual or even a large organization. It's now in the realm of countries and sovreignities. The process is intentionally complex and costly -- it only pays off if you're printing bills for an entire nation.


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