Introducing Superbills — How to obtain reimbursement for your care.
As a fee-for-service medical practice, one of the most common questions involves insurance. While I do not work with insurance at HAVEN for a variety of reasons, I do understand this concern.
For my practice I’ve chosen a system that can provide patients with something called a “Superbill”. Let me explain what that means…
What is a Superbill?
A superbill is a detailed receipt that includes specific information about the services provided during your visit. It typically contains:
Patient's name and contact information
Provider's information
Date of service
Diagnosis codes (ICD-10)
Total amount paid
This document serves as proof of your medical services and can be submitted to your insurance company for potential reimbursement.
How do I submit this document?
To submit a superbill for reimbursement, follow these steps:
Obtain the Superbill: After your appointment, request a Superbill.
Contact Your Insurance: Reach out to your insurance provider to understand their specific submission guidelines.
Complete Claim Form: Some insurance companies may require you to fill out a claims form; make sure to complete it accurately.
Submit the Superbill: Send the Superbill along with any required forms to your insurance company. This can often be done via mail, fax, or sometimes electronically through their website.
Please note, in this process my involvement is limited to creating and sending you your Superbill document. I do not communicate directly with insurance companies or work on claim forms.
Is reimbursement guaranteed?
While many patients successfully receive reimbursement, it depends on your specific insurance plan’s coverage and policies. It's important to check with your insurance provider to understand the likelihood of reimbursement for your particular services
Out-of-Network Benefits: Since my practice operates on a fee-for-service model and does not accept insurance directly, you may be able to file for reimbursement under your plan's out-of-network benefits. This often means that:
Your insurance may cover a portion of the costs, but typically at a lower rate than in-network providers.
You may have a higher deductible or co-insurance for out-of-network services.
Coverage Variation: Each insurance provider has different policies regarding out-of-network care, so it's essential to check with your insurance company to understand:
What percentage of the service costs they may reimburse.
Any limits on the types of services covered.
How your specific plan handles out-of-network claims.
Documentation Required: Ensure that you keep your superbill and any additional documentation your insurance may require for filing a claim.
While there is a possibility of reimbursement, it's important to understand your insurance plan’s specific out-of-network benefits and requirements. Always consult your insurance provider for the most accurate information regarding your coverage. Hope this helps!