Superbill

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Superbill is 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:

Provider Information[edit]

Pascual Herrera 274 North 3rd Street Gadsden,AL 35901 Phone (256)438-5911 Fax (256)438-5933

Patient Information[edit]

Dennis Gibbs D.O.B 09/04/1985 156 Ewing Ave Gadsden,AL 35901 256-453-6853

Visit information[edit]

04/15/2013 05/14/2013 06/13/2013 07/11/2013 08/08/2013 09/05/2013 10/03/2013 10/30/2013

Procedure codes 04/15/2013 99204 05/14/2013 99214 06/13/2013 99214 07/11/2013 99214 08/08/2013 99214 09/05/2013 99214 10/03/2013 99214 10/30/2013 99214

Diagnosis codes 04/15/2013 304.0,533.90,401.9 05/14/2013 304.0 06/13/2013 304.0 07/11/2013 304.0,780.52 08/08/2013 304.0 09/05/2013 304.0 10/03/2013 304.0 10/30/2013 304.0

Office Visit Charges 04/15/2013 $250.00 05/14/2013 $150.00 06/13/2013 $150.00 07/11/2013 $150.00 08/08/2013 $150.00 09/05/2013 $150.00 10/03/2013 $150.00 10/30/2013 $150.00

 'Total Paid to Provider $1300' 

Additional information[edit]

Superbill utilization rules[edit]

  1. 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.[citation needed]
  2. All required fields should be completed (with the exception of those that are considered optional)
  3. Provided information should be readable
  4. CPT and ICD-9 (ICD-10 -Starting October 1, 2014) codes should be marked clearly
  5. 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.)
  6. Only generally accepted medical terminology and abbreviations are allowed

Further reading[edit]

External links[edit]