Superbill

A superbill is an itemized form, used by healthcare providers in the United States, which details the services provided to a patient. It is the main data source for creation of a healthcare claim, which will be submitted to payers (insurances) for reimbursement. There is no standard format for a superbill but it usually covers certain key information about the provider, facility, patient, ICD, CPT and the type of care.

Components of a superbill

Provider Information

The provider information is straightforward. This section includes all of the relevant information regarding the practice when submitting a claim to the insurance. This would include:

• Provider first and last name
• Office location where the visit took place
• Provider phone number
• Provider email address
• Provider signature
• Referring provider name (if applicable)

Patient Information

The patient information section includes all of the patient information needed to successfully submit an insurance claim for reimbursement. This would include:

• Patient first and last name
• Patient address
• Patient phone number
• Patient date of birth (DOB)
• Patient insurance information

Visit Information

The information regarding the visit itself is a critical component of Superbills. Unlike a typical receipt or invoice, a Superbill needs to contain Procedure Codes (CPT), Diagnosis Codes (ICD-10), Modifiers, and additional pieces of data to avoid the denial of claims. This information includes

• Date of visit
• Procedure Codes and Description (CPT)
• Diagnosis Codes and Description (ICD-10)
• Modifiers
• Units or Minutes
• Fees Charged