Understanding Your Out-of-Network Mental Health Benefits: Superbills
If you have ever seen an out-of-network (OON) provider, you likely received a superbill. This document is essential in out-of-network billing and an important tool for receiving reimbursement.
What is a Superbill?
A superbill is a document that details the services an out-of-network therapist or healthcare provider performed for a client. In its simplest form, it is an invoice or receipt for your services. However, unlike a typical invoice, a superbill contains specific clinical information that is crucial for your insurance provider to properly process your claim and reimburse you for those services based on your out-of-network benefits.
What Information is On My Superbill?
The information on your superbill is important for your insurance provider in processing your out-of-network claims. Here is a breakdown of the key information on your superbill:
Provider and Patient Information. This includes names, addresses, and contact information for both the provider and the patient. Additionally, the provider’s information will include an NPI (National Provider Identifier) and an EIN (Employer Identification Number).
Services Provided. A detailed list of the services rendered, which includes the date, location of services, CPT (Current Procedural Terminology) codes, and DX (diagnosis) codes. Need a refresher on CPT codes? Check out our other blog posts.
Fees. The cost of each service rendered.
How Do I Submit a Superbill to Insurance?
Provider generates a superbill. At Uptown Downtown Psychotherapy, we provide patients who wish to receive superbills for self-submission with a monthly superbill. This document is emailed directly to the patient by our practice administrator.
Patient submits to insurance. The patient can self-submit the superbill to their insurance provider along with a claim form.
Patient receives insurance reimbursement. The insurance company processes the claim and reimburses the patient directly based on their plan’s out-of-network benefits.
If you have never submitted a superbill to your insurance company before, it is a good idea to reach out to your provider first and confirm what additional documentation you may need and how to submit your superbill. Many insurance companies have portals that simplify the process but some will request you submit your documents via fax or mail.
Here at Uptown Downtown Psychotherapy, we aim to make your experience as smooth as possible. While we are an out-of-network provider, we are happy to assist you in the process of self-submitting your superbills. We are also able to submit claims on your behalf.
Our practice administrator is available to help you understand your out-of-network benefits, check your coverage, and answer any questions you may have about the reimbursement process.
Have questions? Contact us — we’re here to support you every step of the way