How to Submit a Superbill to Insurance Companies: An Ultimate Guide for Providers

Submitting medical bills to insurance companies might be an uphill battle, especially when it comes to superbills.

We are saying this because even a little mistake can lead you down in the dumps.

For example, if there are coding errors (wrong CPT codes), inaccuracies in patient (incorrect patient ID), provider (incorrect NPI or EIN) or payer (wrong insurance ID) details can definitely pull you back to the wall during the whole billing cycle.

These blunders leave the whole revenue cycle incomplete with a loss of revenue as well.

In case of superbills you may also face the same situation.

Additionally, improper negotiation with patients regarding superbills can also put you in frustration.

So properly submitting the superbills meeting all requirements to insurance companies is equally important for out-of-network providers.

What is a Superbill?

A superbill is an itemized form, healthcare providers use in the United States, which details services with CPT/ICD-codes provided to a patient. It is the data source of generating a medical insurance claim, which they submit to insurance companies for reimbursement.

Superbills have other alternative names like “fee tickets”, “encounter forms”, “charge slips”, or “Statement for Insurance Reimbursement”.

A superbill form includes the date of the appointment, the doctor's information, the patient's information, a list of the treatments provided, the cost of each treatment, and any relevant medical codes. This form acts as a summary of the patient's visit and the services received, making it easier to get reimbursed by insurance companies.

If you're a doctor who's not part of the patient's insurance network, you need to give them a superbill if they ask for one. It's up to the patient to decide if they want a superbill. If they do, they'll need to send it to their insurance company themselves.

In this blog, we will explain how to submit a superbill to insurance companies with whom you are not credentialed.

How to Handle a Superbill as a Healthcare Provider?

There are two ways to handle a superbill:

• Scenario 1: The doctor prepares the superbill and gives it to the patient. The patient then sends the superbill to their insurance company.
• Scenario 2: The doctor prepares the superbill and sends it directly to the insurance company on behalf of the patient.

If you're a healthcare provider, make sure you understand these scenarios so you can help your patients get reimbursed smoothly.

Okay, let's break down those two scenarios with some simple explanations and examples:

Scenario 1: Patient Handles the Superbill

• What happens: The doctor fills out the superbill, which is like a detailed receipt for the medical services provided. They then hand this superbill over to the patient.
• The patient's role: The patient takes the superbill and sends it to their insurance company. It's like submitting a receipt for reimbursement after buying something.
• Example: Imagine you go to a specialist who isn't in your insurance network. The doctor gives you a superbill after your visit. You then mail or submit this superbill online to your insurance company, hoping they'll cover some of the costs.

Scenario 2: Doctor Handles the Superbill

• What happens: The doctor fills out the superbill, but instead of giving it to the patient, they send it directly to the insurance company.
• The doctor's role: The doctor takes on the extra step of submitting the superbill, making it a bit easier for the patient.
• Example: You see a therapist who is out-of-network. They tell you they'll handle the paperwork for you. They prepare the superbill and submit it to your insurance company, so you don't have to.

Key takeaway: In both scenarios, the goal is the same: to get the patient reimbursed for medical services. The difference lies in who handles the superbill submission. Some patients prefer to do it themselves, while others appreciate the doctor taking care of it.

How to Create a Superbill?

To create/generate a superbill on behalf of your patient, you may have to follow a systematic process. Before filling a superbill form, take this essential information with you. 

• Provider’s tax ID number (TIN)
• Patient name, 
• Patient date of birth, 
• Patient phone number 
• Patient address
• The patient’s diagnosis (i.e. ICD-10 codes)
• A specific and detailed list of services performed (CPT codes)

• The total amount charged for services along with the amount your client paid and any remaining balance, if applicable
• Your name, credentials, license, clinic address and NPI number
• Your Place-of-Service Code- You can reference the list of codes provided by the CMS here.
• Your signature and date

Once you have all the necessary information, it's time to generate a complete superbill. There are two convenient ways to create superbills for your patients:

Create Superbill Using Template

A superbill template is like a pre-made form that helps doctors and nurses quickly and accurately record what happened during a patient visit. These templates, which you can often find as PDFs or built into medical office software, make it simple to create complete and correct superbills. They have all the important sections already filled in, like patient information, diagnoses, procedures, and costs, so you don't have to start from scratch every time.

Using these templates has a lot of benefits. They make sure everything is documented the same way every time, which is important for getting paid by insurance companies. They also make the whole billing process smoother and faster, so you get paid sooner. Plus, they save time for the office staff, so they can focus on taking care of patients. And because the superbill is clear and organized, it helps patients understand what they're being charged for, which makes them happier.

Create Superbill Using PMS

Think of Practice Management Software (PMS) as a super-organized digital helper for doctors and their teams. It's way more than just a place to store patient information. A good PMS, like BellMedEx, lets you create superbills right inside the system, so you don't have to mess with paper forms or separate templates. It keeps all your patient details, billing codes, and insurance info in one place, so making superbills is fast, easy, and accurate.

Using a PMS for superbills has tons of benefits. It cuts down on mistakes and saves time because you don't have to type the same things over and over. It also makes it faster to send bills to insurance companies and get paid. Plus, you can easily see which bills haven't been paid yet and how your practice is doing financially.

Want to see how much easier superbills can be? Try BellMedEx's free PMS and discover a simpler way to manage your practice and get paid faster.

How to Submit a Superbill?

There are three methods for a provider to submit a superbill to insurance company on behalf of a patient.

1. By e-mail 
2. By Fax
3. By Website Portal

1). Superbill submission via E-mail

Sending a superbill by email is a quick and easy way for doctors and clinics to help patients get reimbursed by their insurance companies for the care they received. It's like attaching a detailed receipt to an email and sending it to the right place at the insurance company. You don't have to worry about snail mail or faxing anything, which saves time and hassle.

Emailing superbills has a few big perks. It's way faster than regular mail, so the insurance company can process the claim sooner. You also have a digital copy of everything you sent, which makes it easy to keep track of things and check in if you need to. Plus, if the insurance company has any questions, you can just reply to the email. This simpler way of doing things helps everyone – patients get their reimbursements faster, and doctors have a smoother billing process.

2). Superbill submission via Fax

Faxing a superbill is like sending a paper copy of a bill to the insurance company. You print out the completed superbill and use a fax machine to send it to the right number. While some doctors and clinics still use faxing, it's not as common as it used to be because there are now faster and easier ways to do things.

Faxing has a couple of things going for it. It's something that a lot of people in healthcare are used to, and it might be the only option in places where the internet isn't great.

But there are some downsides too. It can take longer for the insurance company to process a faxed superbill, which means it might take longer for the patient to get paid back. Sometimes the fax doesn't go through perfectly, and that can cause problems with the claim. It's also harder to keep track of what's happening with the claim because you don't always get a detailed confirmation. And let's not forget that faxing uses paper and ink, which isn't great for the environment.

3). Superbill submission via insurance company's Online Portal

Submitting a superbill via the insurance company's online portal is the preferred method due to its numerous benefits. The process typically involves logging into the secure portal, uploading the superbill, and providing any additional requested information. This approach streamlines the reimbursement process, eliminates the need for physical paperwork and mailing, and significantly reduces the chance of errors or lost documents.

Additionally, online submission often allows for real-time tracking of the claim status, providing both patients and providers with transparency and peace of mind.

Overall, leveraging the insurance company's online portal is the most efficient and reliable way to submit a superbill, ensuring timely processing and maximizing the chances of a successful reimbursement.

Important Tip: Submit Your Superbill Sooner Rather Than Later

While insurance companies may accept superbills within 90 or 180 days, it's always a good idea to submit them as soon as possible. This helps avoid delays in processing and ensures you get reimbursed faster.

Extra Tip: If you're handling the superbill yourself, consider submitting it online if your insurance company offers that option. It's often quicker and easier than mailing it in.

Superbill Submissions Made Easy with BellMedEx

BellMedEx isn't just about handling routine claims - we're also experts at making superbill submissions simple and stress-free.

We act as a helpful link between patients and providers, ensuring that every superbill is 100% accurate. With our special practice management software, MediFusion, we streamline the whole process from start to finish.

Got a pile of superbills that need attention? Let BellMedEx take care of it! We'll handle everything efficiently, so you can focus on what matters most - providing top-notch care to your patients.

Partner with us, and enjoy:

• Accurate superbills: We'll get every detail right, building trust with your patients
• Efficient processing: Say goodbye to superbill backlogs
• More time for patient care: Let us handle the paperwork, so you can focus on your patients

Ready to simplify your superbill process? Get in touch with BellMedEx today!

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