How to Use a Superbill for Reimbursement
What is a superbill?
Why does Dr. Solano not bill my insurance company for me?
- A receipt or form completed by medical practitioners that allows patients to be reimbursed directly from their health insurance companies.
- Note: A superbill does not guarantee that an insurance provider will pay for the services provided. Each insurance plan is different, and it is your responsibility to contact your insurance provider and find out exactly what will be covered.
How do I find out what my insurance company will reimburse for an out-of-network provider?
- Many professionals do not work directly with insurance companies, choosing to work as independent consultants.
- This ensures that your doctor makes medical decisions that are purely based on professional expertise and not on health insurance policies.
- Additionally, since Dr. Solano does not bill insurance, we do not have to increase our costs to compensate for time spent managing paperwork. This keeps our services affordable for our patients.
The only way to know for sure what your insurance company will pay is to ask them directly. Prior to starting work with a physician who is out-of-network, you should contact your insurance company and find out.
Here is how to contact them:
Release Authorization Statement:
- Call the customer service phone number listed on your card
- Keep your insurance card handy as they will need your account information in order to answer questions about your specific plan.
- Ask, "I want to work with an out-of-network Physician, can you tell you kind of coverage my plan provides?" Inquire about reimbursement for office visits, diagnostic procedures such as labs, and any other services for which you may be referred including nutrition consultation, chiropractic care, and physical therapy.
- Ask, “What is the best way to submit my claim with a superbill?” Be sure to get the address and fax number.
- Be sure that your benefits are clear to you. If anything is confusing, don’t be afraid to ask the same question twice.
Be aware that should you choose to submit a superbill, you are releasing medical information that is protected by law. This means you are waiving some of your rights to privacy and confidentiality. It is standard for your insurance company will have and keep a record of your diagnosis as part of your permanent medical file. These files can be used by insurance companies to set your rates and to allow or disallow further treatment. This policy is no different than when a doctor bills insurance for you.
When sending in the paperwork for your reimbursement, be sure to include the following:
- The superbill
- A photocopy of your insurance ID card, front and back
- Release Authorization Statement
* Be sure to keep a photocopy of all the documents you send in for your records and until you have received the correct payment from the insurance company*