Superbills: What Are They and How Do You Create One?

Regardless of the type of therapy practice you own, at some point a patient will ask you to generate a bill for them. Of course, if they just want a receipt for their personal records then you can give them an invoice with the services rendered and the cost. However, if you own a cash-based physical therapy practice, a regular invoice and receipt might not cut it as oftentimes patients may want to submit the bill to their insurance companies for reimbursement. When that time comes, you do not want to be unprepared. So how do you make sure you are ready when asked? Enter the superbill!

What is a superbill?

A superbill is a document that contains all of the necessary information for an insurance company to decide whether or not they want to reimburse for health expenses incurred by the patient. Typically it is very similar to the claims you submit to a patient’s insurance company, with one main difference…a superbill is submitted directly to insurance by the patient, instead of by your clinic. This is why understanding and knowing how to create superbills are extremely important if you own a cash-based physical therapy clinic.

What are the benefits of a superbill?

Here are some of the main benefits of a superbill:

  • Patients are more likely to agree to and attend therapy sessions, especially if you run a cash-based clinic. If patients know they have a chance of being reimbursed for out-of-pocket costs, they are more likely to feel at ease and continue their sessions.
  • It helps you attract and keep patients who have health insurance, specifically if you are a cash-based clinic. When you can attract and keep patients, you are able to grow and expand your practice.
  • It allows you to spend less time on paperwork because you are not responsible for submitting the claim to the insurance company. Less time spent on paperwork means more time spent focusing on doing what you love – treating patients and helping them return to their prior level of function.
  • It gives you the ability to ask for payment upfront, after each session! When you provide a superbill, it is then up to the patient to contact his/her insurance company and submit the required forms for reimbursement. Superbills also eliminate the reimbursement waiting period that usually occurs after submitting a claim to the insurance company.

How do you create a superbill?

Superbills are not your typical invoice in that they require more than your clinic’s contact info and a broad statement about what services were performed. In addition to adding your clinic’s name, address and phone number at the top of the superbill, you also need to include the following:

  • Your clinic’s tax ID number (TIN)
  • The patient’s information (name, date of birth, phone number and address)
  • The patient’s diagnosis (i.e. ICD-10 codes)
  • A specific and detailed list of services performed (CPT codes)
    • **Please note these should be separate line items which include each service performed along with the cost of each. If applicable, also include any equipment the patient purchased (i.e. therabands, cold packs, etc.) and the cost of equipment as additional line items.
  • 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- this number does not relate to your office’s physical address, but rather where you met your client for the session (i.e. in a clinic vs telehealth). You can reference the list of codes provided by the CMS here.
  • Your signature and date

Remember that the above bullet points must be included on every single superbill that you generate in order for it to be considered a complete document. If you forget to add any of this information, it could result in the patient having difficulty with receiving reimbursement once they have submitted the superbill to their insurance company

With that being said…the easiest way to ensure you have included all of the correct information on a superbill is to create a template that you can easily access and fill out each time a patient requests a superbill. To make your life easier and reduce your stress, HelloNote can generate you one on the fly! You can view the video here:

For all of your billing needs, be sure to check out HelloNote, your one stop shop for physical, occupational, and speech therapy EMR documentation software.

Resources:

https://www.goodtherapy.org/for-professionals/business-management/insurance/article/what-is-a-superbill-and-how-do-i-put-one-together#:~:text=A%20superbill%20is%20a%20detailed,need%20to%20pay%20the%20claim.

https://learnmedicarebilling.com/how-to-create-a-superbill-for-cash-based-therapy-out-of-network-claims-office-ally-practice-mate/

https://www.carecloud.com/continuum/what-is-a-superbill/

https://www.icanotes.com/2019/12/17/what-is-a-superbill/

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