What’s a superbill?
It’s a bird! It’s a plane! It’s a… superbill?
If paying for out-of-network health care is your arch nemesis…a superbill may come to save you in some instances.
If you use traditional health insurance for healthcare, you may have noticed a trend in recent years of healthcare providers leaving insurance networks.
High administrative burden and unsustainable reimbursements are common drivers of providers leaving networks, but that doesn’t always mean patients will be stuck with the full bill if they work with an out of network provider.
What’s a super bill?
A superbill is a detailed receipt from your healthcare provider. It shows the services you received and what you paid. Patients use superbills to ask their insurance company for reimbursement when the provider doesn’t bill insurance directly.
A superbill usually includes:
Provider name, credentials, and contact info
Diagnosis codes (ICD-10)
Service codes (CPT)
Dates of service and fees paid
Your name and date of birth
What Insurance Plans Accept Superbills?
Many PPO (Preferred Provider Organization) plans accept superbills for out-of-network reimbursement.
Plans that typically do accept superbills:
PPO plans
Some POS (Point of Service) plans with out-of-network benefits
Plans that typically do not accept superbills:
HMO plans
EPO plans
Medicaid and Medicare (in most cases, some Advantage Plans may)
Every plan is different, so it’s important to check your specific benefits.
How Do I Submit a Superbill?
Check your insurance benefits
Confirm you have out-of-network benefits and ask or find out how to submit a claim.Get your superbill
Ask your provider for a superbill after your appointment.Complete a claim form
Download the form from your insurance company’s website or request one.Submit the claim
Send the completed claim form and superbill:Online through your insurance portal
By email, fax, or mail (depending on the insurer)
Wait for reimbursement
Processing can take weeks. If approved, reimbursement is usually sent to you directly.
Reimbursement amounts vary based on your plan, deductible, and out-of-network coverage—submission does not guarantee payment.
Final Thoughts
We know it stinks to have health insurance and not get to use it easily and a superbill isn’t the health insurance hero we’re all looking for.
Northbound Physical Therapy and Wellness does not take insurance because it wasn’t a good fit for they way practice care, but we support you making the right decision for your needs whether that’s seeking an in-network provider or providing you with a superbill to seek reimbursement from your insurance.
Give us a call or set up a free consultation if you have more questions!