What is a Superbill?
If your provider is out of network you may have heard the term “superbill.” When you see a provider that is not in network with your insurance, most practices will provide a standard form called a superbill for you to submit to your insurance for reimbursement. The superbill is like a detailed receipt and contains important information commonly requested by insurance companies, such as the date of service (DOS), place of service (POS), patient information, provider information, procedure code(s) or CPT code(s), all applicable diagnosis code(s), and associated fees.
The process for using a superbill when seeing an out of network provider looks something like this:
When you make the appointment, it is always recommended to call your insurance’s Member Services number to verify your benefits prior to the visit. We have an easy to use form that has all the recommended questions to ask your insurance provider, contact us here to request a copy! Plan for this call to take about 10-20 minutes. If you are out of network, ask about out of network benefits and their process for submitting superbills.
Note: Confirm that the address they have on file for you is accurate, this is where your documentation and reimbursement check will be sent!
After seeing your speech or occupational therapist and paying for services out of pocket, you will receive a superbill to submit to insurance. This can typically be done via fax, mail, or uploading via your insurance company’s website.
Turnaround can vary, but typically you’ll hear back within about 2 weeks. You can always call to ask about the claim status.
When the claim is finalized, you will be reimbursed according to your individual insurance plan. Some insurance companies mail a check, while others offer Electronic Funds Transfers online.
Note: After reviewing a claim submission, some insurances want more information before finalizing the claim and providing reimbursement. Talk to your therapist if you need to submit more documentation such as an evaluation report, plan of care, or daily progress note. Therapy Adventures provides these extra documents free of charge whenever they are needed!
At Therapy Adventures, our goal is to make this process as easy as possible. We are always happy to help families navigate process of insurance reimbursement when we are out of network. Don’t hesitate to reach out with any questions you have during this process!
Therapy Adventures, PLLC is a private practice in Dripping Springs, TX specializing pediatric speech therapy, language therapy, occupational therapy, and feeding therapy. Learn more about us here!