A Superbill is a detailed, itemized receipt provided by a healthcare professional that patients use to seek reimbursement from their health insurance company for out-of-network services. It is not a bill itself, but a standardized document that acts as a ready-to-file insurance claim form for the patient.
Superbills are typically used when a patient sees a provider who does not have a contract with their insurance plan (an out-of-network provider). Here is a brief summary of how they work.
Patient Pays Upfront: The patient pays the provider the full fee for the service at the time of the appointment. An insurer will only reimburse you for services you have already paid.
Bluefield Psychological Services Issues Superbill: We give you a completed superbill, an electronic document, detailing the services rendered.
You Submit Claim: You then submit the superbill and any required claim forms to your insurance company (usually via an online portal, mail, or fax).
Insurance Processes: The insurance company reviews the documentation and, if your plan includes out-of-network benefits, reimburses the you directly for a portion of the costs.
You may be wondering why Bluefield Psychological Services is not in-network with your insurance. The process of joining an insurance company’s network is often lengthy and complex. Mental health providers must apply to each individual insurance panel (such as Blue Cross Blue Shield or Aetna), which typically involves extensive paperwork, credentialing requirements, and approval timelines.
Using superbills allows Bluefield Psychological Services to provide care and receive payment without being contracted with every insurance provider panel. The alternative would be to limit services only to clients whose insurance plans the practice is credentialed with. A superbill serves as a helpful tool to navigate these administrative barriers, allowing greater flexibility for both the provider and individuals seeking care while still offering the option of potential out-of-network reimbursement.
Before filing an out-of-network claim, it is important to understand your specific out-of-network benefits. The easiest way to do this is typically by reviewing your plan details through your insurance provider’s website. You may also contact your insurance company directly using the phone number listed on the back of your health insurance card.
What Information Is Included on a Superbill?
To help clarify the process, below is an overview of the information typically required when submitting a superbill.
Contact Information: A superbill includes essential client details such as name, date of birth, address, and phone number. It also lists the provider’s information, including the practice name, office location, and National Provider Identifier (NPI). An NPI is a unique identification number used to identify healthcare providers for billing and administrative purposes.
Dates and Costs of Service: Superbills list the date and cost of each service provided. A superbill may include a single appointment or multiple appointments (which is what makes them “super”), but each service must include both the date and the corresponding fee.
Diagnosis Codes: Diagnosis codes are included to classify presenting concerns and symptoms. These codes are standardized identifiers used by insurance companies. Currently, providers use the International Classification of Diseases, 10th Revision (ICD-10).
Procedure Codes: Procedure codes—referred to as Current Procedural Terminology (CPT) codes—describe the type of service provided. These codes are developed by the American Medical Association and distinguish between services such as intake evaluations, individual psychotherapy sessions, and other clinical services.
Additional Guidance
We hope this overview helps make superbills feel less intimidating. Occasionally, insurance claims are denied due to minor or easily correctable issues. Bluefield Psychological Services is happy to help clarify information or guide you through the correction process if needed. Successfully resolving a rejected claim can result in reimbursement of a significant amount of money .
If you prefer additional support, there are also third-party services designed to submit out-of-network claims on your behalf. Some of these services are free, while others charge a fee. These services aim to streamline the submission process, address claim rejections, and advocate for reimbursement. Other options are available, however one example is www.superdial.com.