In healthcare, Superbills are the standardized receipt that Registered Dietitians can give clients that details out services rendered in session. Clients can then submit this receipt directly to their insurance provider, for possible full or partial reimbursement for MNT services.
Even if you aren’t credentialed by insurance, or if you’re considered out-of-network by some carriers, you can still provide a Superbill to your clients for a chance their services will be covered. And your clients will still pay for your services as usual, so you get paid — but it’s a great way to potentially reduce the cost of care for your clients.
In this deep-dive article, we’ll cover:
- Managing client expectations regarding Superbills and their financial obligations
- Step-by-step how to fill out a Superbill
- How to create a Superbill within Healthie
- Next steps — you’ve created a Superbill, now what?
Superbills: Provider or Client Financial Responsibility?
The first step to understanding how to navigate Superbills, is to clearly define where financial responsibility lies. More than anything, a Superbill is a receipt of service, given to a client after the client has paid and services have been rendered. Nutrition providers will give a Superbill in the event that they do not accept insurance in their practice, or are out-of-network from the client’s insurance plan.
The reimbursement rate is determined by the client’s insurance provider, and it is not the nutrition provider responsibility for knowing or guaranteeing any type of reimbursement. As reimbursement cannot be assured, it’s in the nutrition providers best interest to always have client’s pay directly at the time of service.
Once the client submits the Superbill to their insurance provider, the request will be processed and any possible reimbursement will be sent directly to the client. All questions, or concerns that a client has regarding their Superbill can best be answered by their insurance provider. Being upfront with this process will help clients know what to expect, and make clear that they are financially responsible for paying for nutrition services as usual.
Filling Out a Superbill: Step-by-Step Instructions for Nutrition Professionals
The Superbill form is a standard form that can be obtained online, or is provided directly through the Healthie platform to Healthie providers. It can be filled out by Registered Dietitians. Whether credentialed with insurance or not.
Step 1. Client + Provider information
You’ll need some basic information from your client, which you likely have already captured through their intake process, including:
- Date of birth
- Phone Number
Step 2. Tax ID number
This is your EIN number (employer identification number or business tax ID). An EIN is a unique nine-digit number that you use when filing taxes for your nutrition practice. Nutrition providers can obtain an EIN for their nutrition practices through the IRS, via their online application portal. It’s free to apply, and only take 10 minutes to obtain your EIN through the IRS website.
Step 3. NPI Number
An National Provider Identifier is a 10-digit identification number that dietitians can obtain through CMS. It has been adopted as the standard provider identifier and most healthcare providers. Whether you work with insurance providers or not, it is beneficial to apply for an NPI number. It only takes a few minutes and can easily be completed online through the NPPES website.
If you do not have an NPI number, you can leave this blank on the Superbill.
Step 4. Referring Provider Name and NPI
If you work directly with insurance companies, you likely have already obtained your client’s MD referral information. For certain insurance plans, an MD referral is required for reimbursement. If you don’t have the information, you can leave it blank on the Superbill, but your client may not receive reimbursement.
Alternatively, you can ask your client to contact his MD (or you can reach out directly if your client has signed a medical consent release) and ask the doctor to E-Fax a referral. The office administration can likely also provide the MDs NPI number if not included in the referral.
Step 5. Diagnosis and CPT Codes
As Superbills are aimed at helping clients be reimbursed for medical nutrition therapy services, at least one ICD-10 code and one related CPT code will be required to justify the services rendered.
In best practice, a medical diagnosis should be included in the MD’s referral or client’s medical records. The associated ICD-10 code can then be obtained and filled out on the Superbill Claim. CPT codes are used to define medical, surgical, and diagnostic procedures. There is a code for each procedure performed, specified by a 5-digit number and describes the service provided related to the ICD-10 code.
Step 6. Payment details and date of service
In this section, you’ll want to list relevant payment information. Reimbursement to a client via Superbill will be considered based on what the client paid. Nutrition providers will not receive any amount of money from the insurance provider, and should not mark up their rates in anticipation of a client receiving reimbursement.
It would also not be advisable to allow a client to forgo paying the full amount in hopes of applying their reimbursement towards the remainder. As part of your initial financial discussions, reinforce that the client is responsible for 100% of the service charge and any reimbursement payments will be negotiated between them and their insurance provider.
Payment details listed on the Superbill:
- The total charge to client nutrition services rendered
- How much the client paid
- The remaining balance (if any)
- Date of service — multiple sessions can be submitted in the same claim, but be sure to indicate the date of service for each separately
Creating a Superbill Through Healthie
The Healthie platform supports nutrition providers in:
- Generating a Superbill
- Sending a Superbill directly to a client
- Tracking the status of the Superbill
Superbills can be generated through the Healthie charting platform by navigating to the client’s chart. Select the chart note you’re generating the claim for (remember, claims can be submitted for multiple services, but the date of service needs to be listed for EACH session). Once selected, you’ll view a button on the top right of your screen “Create a Superbill.”
From here, the platform will automatically pre-fill the Superbill form with client and provider information. You can then edit the form directly, and add the relevant diagnosis code. For your convenience, there is a dropdown listing commonly used codes.
You can also generate Superbills by navigating to Billing from your Healthie provider dashboard. Below, Billing, you’ll see “Superbills,” which will allow you to see an overview of all Superbills every created, their status and the option to create a new Superbill.
You’ve Completed a Superbill, Now What?
Upon completing the form, you’ll have the option to download the Superbill, or click > MORE to send it directly to your client through Healthie. The Superbill will be sent via email to the client, and the “status” for the Superbill will change to “Sent.” Clients submit Superbills to their own insurance companies directly, and any reimbursement will be sent to the client. Following up with client’s in the future, nutrition providers can then change the status of the Superbill within Healthie to “Rejected” or “Reimbursed” for your records.
For Healthie Members: here’s our list of resources and help articles to assist you in navigating the Client Packages platform.