The Superbill: What It Is and Why You Need It

Any time a therapist hears the word “bill”, you can almost hear the inevitable sigh that follows. Billing is one of those practice necessities that drive therapists crazy. No one likes to deal with it but we do like to be able to keep the doors open.

For insurance billing, you most likely utilize some type of software or have a claims service. But what happens when a client asks you for a bill?

Whether or not you participate on insurance panels, at some point, you are probably going to be asked to generate a bill for a client. More and more, clients are participating in some type of health savings plan. Still others are faced with insurance plans that require meeting deductibles. To access those plans and funds, clients are required to submit bills for covered services. Do you know what to give them? Enter the superbill.

What Is A Superbill?

A superbill is a document that contains all of the information necessary for an insurance company or other third party to make a decision on reimbursement for health expenses incurred by a client. It is not a receipt. It is not an invoice. It is not a claim.

A superbill is similar to a claim that you’d send an insurance company. However, not every client you see has insurance that you would bill directly so would generally not be in a billing (claim) queue. The client may have an HSA or they may be utilizing out of network benefits and needing to meet a deductibles. Or you may not work with insurance panels at all. A superbill provides the client with the information they need to work directly with their respective plans.

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Beyond Receipts & Invoices

When a client pays you directly, you may provide them with a receipt. It may detail the date, the client’s name, your name and maybe the specific service. The same may hold true for invoices. You would generally not include details related to a client’s specific services or diagnosis on such documents.

For many clients, a simple receipt or invoice may be all they need. Those who are going to seek reimbursement from a third party will need considerably more specific and highly protected information.  

What’s In a Superbill?

Like an insurance claim, a superbill contains specific information related to the client, the service, the provider and – here’s the really important part –the client’s diagnosis. It is this information that a third party will consider when making a decision as to whether the service meets the requirements of the plan.

Here is the information generally included on a superbill:

• Client’s identifying and contact information
• Provider’s name and credentials
• Office address & phone number
• Provider’s tax ID
• Provider’s NPI
• Date(s) of service
• CPT code for the service ICD-10 code
• Fee for the service paid by the client

For a client not already in a billing database, that is a lot of information to have to generate each time a client asks you for a superbill. What’s a therapist to do?