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What is a Superbill? What Information Does it Contain?

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A medical superbill or encounter form being prepared

What is a superbill?

A medical superbill or encounter form is the primary source of data for preparing claims and contains the list of services provided to a patient. Along with the list of services, the superbill will show the costs and codes for each exam, treatment, or procedure. It will also contain information about the patient, provider, CPT codes, ICD-10 codes. These details have to be accurate so that claims can be prepared correctly.

A superbill is not necessarily needed for preparing claims by the provider. However, a patient would require a superbill in case (i) the provider is not part of their insurance company’s provider panel, (ii) they are having a Health Savings Account (iii) they are utilizing out of network benefits and need to meet a deductible(s). In these cases, the superbill helps the patient to work directly with their insurance plans.

Information contained in the superbill has three parts.

The first part will contain all the patient information

  • Name in full
  • Address
  • Phone number
  • Date of birth
  • Insurance details
  • Date of the first symptom

The next part is provider information

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

The final part is information regarding the patient visit, which is vital and it includes

  • Date of visit
  • Procedure Codes and Description (CPT-Current Procedural Terminology)
  • Diagnosis Codes and Description (ICD-10 – International Classification of Diseases Tenth Revision)
  • Code Modifiers
  • Time
  • Units
  • Quantity of items used
  • Authorization information
  • Fees charged item-wise (to understand what is being charged and why)

Notes made by the healthcare provider and comments that would help in the claims processing may also be included in the medical superbill to justify medically necessary care. Additional information in the superbill may help get the patient additional insurance coverage.

How Bristol Healthcare can help you

Our team of billers at Bristol Healthcare Services will ensure that all the information about provider, patient and visit are obtained and the superbill populated. We will ask for and collect all the additional information available if the situation warrants it. All of the above information, when included in the superbill, makes it clear and organized, thus translating into clean claims that will be processed successfully. Effective superbill designing makes the reimbursement process easy and quick. Patients are happy when there is more insurance coverage for them and less co-pay.

Bristol Healthcare Services is a medical billing and coding company serving medical professionals for over two decades. By virtue of its commitment to its clients, our company has become one of the best in the industry.

Let our team of expert billers take care of your superbill designing and other medical billing services. Rest assured that you can focus peacefully on your clients. Your practice will expand and so will your revenues.

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