Sometimes when a patient wants to get reimbursed by their insurance company after they have paid for the service, you will have to issue a superbill for therapy instead of a receipt or an invoice. However, there are many therapists who don’t use superbills in their practice, as it takes time and effort to correctly fill them out. Moreover, the superbills often get declined by insurance providers because of outdated or incomplete data, and it’s challenging to keep the information in superbills secure.
Let’s learn what benefits superbills provide you as a therapist and check what you can do to avoid a rejected superbill.
What is a superbill for therapy?
A superbill is a detailed invoice that contains information on all the services the patient has received from you during one session, your practice information, and detailed information about your client. However, a superbill has specific components and can’t be replaced with a regular invoice.
Let’s check out what the differences between an invoice and a superbill are.
|Features||An invoice||A superbill|
|Shows the total charged amount|
|The patient gets a reimbursement|
|Describes the provided services in detail|
|Has to include procedure codes and descriptions|
|Has to include ICD-10 codes and descriptions|
|Includes detailed information on the patient and service provider|
|Has to meet the requirements of insurance companies|
In fact, a therapy superbill is used when your patient wants to be fully or partially reimbursed (depending on what services the insurance covers), as they have already paid for your services. Using superbills also makes therapy services more accessible to those who may not be able to afford the full price of a therapy session.
How therapy superbills work
Now that you know some of your patients might want you to issue superbills for them, it’s important to understand how the system actually works and what place superbills take in your workflow.
When you map out the billing processes in your therapy practice, you most likely let the patients pay prior to the therapy session or request payment right after it.
After payment, you’ll have to create a superbill and send all the required information to the insurance company to reimburse the patient. Alternatively, you can provide a superbill to your patient and let them send it themselves.
At first sight, everything looks easy, so why doesn’t everyone use therapy superbills? First of all, creating superbills requires extended data that must be organized according to the insurance company’s requirements (these requirements differ for each company). Secondly, you will need more information about your patient and must ensure it is up-to-date. Finally, the superbills you issue can get rejected.
These challenges are why we recommend that you discuss the billing process with your patients before providing any services to them. This initial communication can help you avoid surprise billing and be sure that your patients know the terms on which their insurance company covers therapy services.
After all, superbills do have advantages. By using superbills, you:
- minimize the risk of not getting paid for provided services
- help patients who can’t pay for your services out of pocket afford therapy
- don’t have to join the insurer’s provider panel
What information should a therapy superbill template contain?
Insurance providers may set different requirements for superbills. That’s why, to avoid superbill rejection, it’s important to double-check what your patients’ insurance companies need to get from you.
Make sure you include the following types of information in the therapy superbill.
Information that helps to identify your patient
You need your patient to provide you with this type of information and confirm its accuracy before adding it to the superbill. Information that identifies your patient includes the:
- patient’s first and last name
- patient’s address
- patient’s phone number
- patient’s date of birth (DOB)
- patient’s insurance information
Note that all this data is considered protected health information. To collect and store it, you will have to use HIPAA-compliant forms and a CRM system that offers HIPAA-compliant profiles.
Information about your practice
This information has to be correctly added by you. Often, insurance companies will request:
- Your first and last name. Add your full name as it is written on your license and certificates.
- Your NPI number. This is a unique 10-digit identification number that every healthcare provider should have to be eligible to practice. You can double-check your number in an online NPI registry.
- Your tax ID. A tax ID is necessary for tax deduction purposes.
- Your license number. Your number proves that you’re eligible to provide therapy services. It’s often added at the top of the superbill.
- Your office location. If you provide online therapy sessions, your office location is the address where you work remotely.
- Your phone number. Include the phone number that you use in your therapy practice.
- Your email address. You need to include the official email address you use in your therapy practice.
- The provider’s signature
- The referring provider’s name (if applicable)
- The referring provider’s NPI number (if applicable)
Information about the visit
The following information needs to be detailed and accurate as the insurance provider might cover only some therapy services. Be sure you have included:
- the accurate date of the visit or online session
- up-to-date procedure codes and descriptions (CPT)
- a descriptive modifier (if a general modifier is used, the insurer can request a medical record to check if it’s appropriately used; if it’s not, the superbill can be rejected)
- updated diagnosis codes and descriptions (ICD-10)
- units or minutes to specify the length of the session or procedure
- fees charged for each service or procedure completed in one session
A therapy superbill template might look as follows:
However, sometimes insurance providers might request information you haven’t included in the template, so be ready to adjust it to meet new requirements.
It’s also helpful to regularly update information, as this can be the cause of superbill rejection. Also, always keep track of issued superbills. If they are rejected, resubmit them after correcting the errors.
What are the possible challenges of using superbills?
Sometimes therapists refuse to use superbills because creating them can be difficult. Let’s check out what challenges and issues therapists might face and find out if it’s possible to overcome them.
Monitoring insurance companies’ superbill requirements
The information you are required to provide in therapy superbills as well as the templates that are accepted often change with time, so it’s essential to check the requirements of each insurance company before you send a superbill. Otherwise, the chance of getting a superbill claim rejected is high.
Keeping tabs on the changes in ICD-10
You may have heard that there are constant updates and changes happening in the International Classification of Diseases. You have to be aware of the classification that is required and generally accepted in order to submit a superbill and ensure it will be approved. At the moment, ICD-11 has been created, but it’s still not ready to be implemented in the U.S. Make sure you are keeping tabs on all the changes happening to avoid using outdated classification or classification that isn’t approved yet.
One of the most critical questions is how you can securely collect, store, and send your patients’ protected health information. You have most likely heard about HIPAA Privacy, Security, and Omnibus Rules that are applicable to the data you need to submit to insurance companies. These types of data need extra protection, so you can’t use Google forms, for example, a database that is not HIPAA-compliant or Gmail services that don’t provide you with a BAA agreement.
You will have to find a solution that will let you:
- send protected forms to your patients and store the received information
- create and update patient profiles based on this data
- securely send documents
You can cover these security concerns with a powerful CRM solution for therapy practices.
Want a ready-to-use superbill template? Feel free to ExpertBox to ensure you collect and store ePHI in a HIPAA-compliant way.
How to prepare therapy superbills
There are several ways you can create a HIPAA-compliant superbill.
The first way is to create a superbill in a document that is password-protected and based on the data stored in your CRM, or you can use a ready-made template and manually fill it in.
Want a ready-to-use superbill template? Feel free to download it here!
The second option is to use a platform that will let you automate superbill creation. However, you should know that with the changes in requirements insurance companies set for therapy practices, sometimes this approach will lead to superbill rejection.
To create a smooth workflow that will let you create and safely submit superbills, we advise you to:
- Automate invoicing. If you have all the information ready for regular invoices, you will have most of the information you need to prepare a superbill as well.
- Automate accepting payments. This will ensure you’re always aware of the payment methods your patients use.
- Keep track of payment statuses. This easy step will reduce the chances that your patients pay late.
- Regularly update client profiles. To do this, you can either notify your patients that they need to check the accuracy of the data in their profiles or ask them to fill in the missing data using HIPAA-compliant intake forms.
- Send invoices to clients to let them know there are no hidden fees. This approach will minimize the chances that patients will have false expectations about insurance covering services that weren’t included in their plans. They’ll be able to keep track of their expenses and will know what their reimbursements will include.
- Create, send, and monitor the status of superbills. The most common mistake is failing to monitor the superbill status, as sometimes they are rejected and an insurance provider requires you to add or verify some data. If you don’t track the superbill status, the reimbursement can take months.
Creating superbills for therapy is a safe alternative if you don’t want to join the insurer’s provider panel. Just ensure your superbills are accurate and HIPAA-compliant so that your patients receive reimbursements.
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When you map out the billing processes in your therapy practice, you most likely let patients pay prior to the therapy session or request payment right after it. After payment, you’ll have to create a superbill and send all the required information to the insurance company to reimburse the patient. Or you can let the patient send a superbill you’ve provided them with.
A superbill often includes information such as:
- the patient’s first and last name
- the patient’s address
- the patient’s phone number
- the patient’s date of birth (DOB)
- your first and last name
- your NPI number
- your tax ID
- your license number
- your office location
- your phone number
- your email address
- the referring provider’s name
- the referring provider’s NPI number
- the date of visit or online session
- procedure codes and descriptions
- a descriptive modifier
- updated diagnosis codes and descriptions
- units or minutes
- fees charged
A superbill is a detailed invoice that contains information on all the services the patient has received from you during one session. A superbill also includes your practice information and detailed information about your client. However, an invoice won’t contain CPT and ICD-10 codes and doesn’t need to meet the requirements of insurance companies.