Superbills: What They Are and When You Need Them

Is it a bird? Is it a plane? No, it’s a Superbill!

For clinicians based in the US, superbills are yet another administration task to add to the list. But, if you’ve made good life choices, your practice management software is here to save the day by streamlining the process, increasing the accuracy of your superbills, and ensuring that you can accept all patients, regardless of which insurer they use.

But, if you’re wondering, ‘super what?’, unsure of the best way to formulate your superbill or if you should be using them at all, this article is about to rock your world.

Here’s our A to Z on superbills and why they might be great for your practice.

What Is a Superbill?

A superbill is a type of invoice providing a detailed breakdown of the treatments received by your client or patient.

A superbill isn’t needed when clients request their medical records or an ordinary invoice. Instead, it’s a document required by insurance carriers for client reimbursement. It has a full breakdown of all areas of treatments, the costs of each, and the client’s diagnosis.

Why Use a Superbill & Who Needs It?

As a therapist or health practitioner, you’ll need to create a superbill when your practice doesn’t appear on your client’s insurance company panel, or if the client is out-of-network. It contains all the information required by the insurer to reimburse the client.

Being listed on various insurance panels is a win, as it makes payments quicker and helps clients who don’t have the means to outlay the cost of treatment. However, there are many different insurers, and it may not be practical to join every panel as it can be a lengthy and detailed process.

In essence, a superbill provides the best of both worlds: you can accept clients who have insurance without being in every single provider network.

Perhaps you can opt for joining only the most popular insurance providers and have a streamlined process for submitting to panels that you haven’t joined?

Other reasons why you may opt for superbills include:

You’re still waiting to be accepted onto a panel;
You’d prefer not to join provider panels;
Your practice lacks the resources to join smaller and less popular insurers, but you’d rather not exclude some of your clients;
You’ve chosen to be selective about the insurance panels you join.

A friendly reminder to always discuss payment options upfront with your clients before their first appointment, to avoid straining relationships or surprising them with unmanageable terms.

International Statistical Classification of Diseases (ICD-10) & Superbills

The 10th edition of the International Statistical Classification of Diseases (ICD-10)2 went into effect in 2015, and thus the superbill with updated diagnostic codes is now required. You’ll need to produce one for each consultation with your client.

How Superbill Payments Work

Generally, you’ll need to send superbills to clients on a monthly basis. You must also ensure that your forms and treatment notes are in line with the billing codes so that you’re fully ICD-10 compliant.

Superbills differ from traditional invoices because your client will settle the original bill with your practice, and their insurer will then reimburse them based on the superbill. This is the case even if you, as the practice, submit the superbill to the insurer.

The reason for this is that the payment is seen as a reimbursement, with the insurer assuming that the client has already covered the cost of treatment. Therefore, you must ensure that your client has settled the bill with you fully before submitting the superbill with ICD-10 codes.

If you feel overwhelmed by the thought of the additional admin, or you simply don’t have the infrastructure or tools, you can opt to only see clients whose insurers pay directly for your services.

However, this limits your pool of possible clients, so it’s worth weighing up the pros and cons of offering treatment to everyone, regardless of their insurer.

And then, you have another card up your sleeve. If you use Zanda as your practice management software, it’s much easier to submit superbills. Our interface streamlines the process, reducing mistakes that could delay payment to your client.

Create a Superbill in 6 Steps with Zanda

American practitioners love our clinic management software because you can customize your client setup and invoices to create superbills for insurance reimbursement. And, as an extra benefit, the software is designed with the best global security technology to protect your clients’ private information.

Your superbill must include the following details:

Your NPI Number – This can be easily added to your calendar. It’s a case of simply navigating to Setup > Calendar, then select the calendar you want to add an NPI number to from the list on the left, entering the NPI number into the Custom Invoice Text field, and clicking ‘Save’. From now on, your NPI number will appear below your name on all printed and downloaded invoices.
Adding Referring Provider Information – This can be readily displayed on your invoice. Just follow the steps in the Knowledge Base article about adding and editing referrals.
Adding Patient Insurance Information – You can use Zanda’s insurance functionality to add new insurance companies and add insurance information under your clients’ billing details.
Recording Diagnosis (ICD-10/DSM Codes) for Patients – You can simply record patient diagnoses by adding ICD-10 or codes in the billing setup. You can use the Extra Invoice Info field.
Recording Procedures & Descriptions (CPT) – You’ll have the opportunity to add these under services.
Creating a Superbill – For your convenience, you can generate a superbill under your billing section in Zanda.

Need a step-by-step walkthrough? Zanda’s Knowledge Base covers how to create superbills in Zanda and how to generate superbill statements.

In Conclusion

Offering superbills can increase your practice’s growth prospects, and with Zanda, your administrative load is significantly lighter. With just a few simple steps, you’ll be well on the way to creating superbills for your clients, regardless of who their insurer is.

About Damien Adler

Damien Adler is a registered psychologist, best-selling author, entrepreneur, and Co-Founder of Zanda. He has a background in health administration, having held senior positions in the public health sector. He later founded a successful group private practice, and it was there that Damien discovered his passion for using technology to make life easier for health practitioners. These days, Damien dedicates his time to improving healthcare practices through technology. His unique insights stem from working closely with thousands of practitioners worldwide, from hospital settings to private practices, allowing him to identify universal challenges and opportunities within allied health. Damien's unique blend of practical experience and technological insight makes him respected in advancing healthcare practice efficiency and effectiveness.

Superbills: What Are They, And Do You Need Them For Your Health Practice?