Superbills or CMS 1500s? What’s the Difference?

Whether you are just starting to take insurance at your private practice, or are interested in learning more, you may have questions on two very important insurance forms–superbills and CMS 1500s.

What are they?

A superbill is essentially a receipt of the services you have provided your client. Clients can submit these to their insurance companies to (potentially) get reimbursed for your services.

A CMS 1500 is an insurance claim form for non-institutionalized healthcare providers (such as private practice dietitians). If you come from a clinical background, a CMS 1500 is like a UB-04. You fill out this form each time you wish to submit an insurance claim.

How are they different?

The short version:

You use a CMS 1500 form when you are an in-network provider with an insurance company. You use a superbill when you’re not an in-network provider.

With a superbill, you still accept out-of-pocket payments for your services, but your client can receive reimbursement for their bill by submitting their superbill to their insurance company.

We sometimes call superbills the “Junior Varsity” version of offering insurance benefits to your clients. Providing a superbill will give your clients a chance to receive a reimbursement through their insurance company.

Pro Tip: Whether you’re creating a superbill or CMS 1500 form, there is a LOT of information to collect. Especially with the CMS 1500 form.

Healthie makes insurance forms easy.

Collect the need-to-know details right with an intake form. Fill out your CMS 1500 form or superbill once, and it will save to auto-fill the information that client for the next time! Breeze right through insurance with Healthie!

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