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Superbill is an itemized form utilized by healthcare providers for reflecting rendered services. Superbill is the main data source for creation of healthcare claim, which will be submitted to payers (insurances, funds, programs) for reimbursement. Although the superbill form is not unified, and it is created/modified depending on healthcare provider specialty, type of rendered services, additional requirements, as well as ease of handling, there is a set of obligatory attributes, relevant to all superbill types.
Superbill form consists of 4 main parts, containing mandatory fields to be completed for accurate claim creation:
Procedure codes (CPT) – list of commonly used codes by medical provider according to the provider specialty
Diagnosis codes (ICD-9) – list of commonly used codes by medical provider according to the provider specialty
Modifiers (Location and conditions modifiers)
Time (for timed codes)
Quantity for drugs
Authorization information (if applicable)
Notes and comments (for e.g.: PT cap)
Superbill utilization rules
Each superbill must be signed by rendering provider of service. Superbill without a signature cannot be processed by medical biller. By signing the document the healthcare provider is acknowledging the services rendered and confirming that information on superbill is permitted to be sent to insurance company by medical biller.
All required fields should be completed (with the exception of those that are considered optional)
Provided information should be readable
CPT and ICD-9 (ICD-10 -Starting October 1, 2014) codes should be marked clearly
In case if required CPT or ICD-9 code could not be found in the given list, Provider should give legible handwritten description of service/diagnosis, along with additional information (units, time, type, etc.)
Only generally accepted medical terminology and abbreviations are allowed