What is a Superbill"?
What is a Superbill?
A superbill is a document that shows a list of services you received from a healthcare provider.
You may need to submit a superbill to your insurance company to receive reimbursement for services that are out of network
How does a superbill payment work?
Typically, superbills are provided to clients and insurance companies that are out of network. If a practitioner is out of network, they are not accredited or connected to your insurance carrier. That means treatment and sessions may not be covered by insurance.
As such, your therapist won’t submit for payment to your insurance company. Instead, you can request to be reimbursed by your insurance company for a part if not all, of your costs. A superbill is your key to doing this.
How do you know if you have coverage for nutrition services?
You can contact your insurance provider to learn if you have out-of-network benefits. Medicare recipients do not have out-of-network benefits. It is important to know what your benefits are before beginning treatment.
Also, ask if you’ll need prior authorization for out-of-network services.
If your insurance provider confirms that you have out-of-network benefits, you may be reimbursed for some or all of the costs you paid out of pocket!
Here’s how to check your benefits: (*Be sure to record the answers!)
Call the phone number for customer service, which is usually located on the back of your insurance card. If your employer provides your plan, your HR department may be able to call on your behalf.
You will want to speak to the benefits and coverage department.
You want to know if Medical Nutrition Therapy (MNT) and/or nutritional counseling is a covered in-network benefit for your plan.
Ask them to check coverage for “Telehealth.”
Let them know that services will take place in ________________ .
Ask them if coverage is dependent on a diagnosis (Medical Nutrition Therapy - MNT)
Provide them with your nutrition-related diagnosis (ie: eating disorder, diabetes, obesity, etc).
If you do not have a medical diagnosis,
Ask if there are any benefits for “preventative Z codes” such as
Nutritional Counseling
Inappropriate diet and eating habits
Intervention and surveillance
If there is a benefit, ask if there are any restrictions:
Does the policy cover Telehealth services? Which codes? Are modifiers required?
How many Telehealth visits/units are covered? Is this monthly or annually?
Is it a calendar year or benefit year?
Can you use a registered dietician or does it have to be a specific practicioner? (via Telehealth)
Ask if you will need to pay a copay, deductible, coinsurance, out-of-pocket max, etc.
Record the information above as well as the reference number, and who you spoke with.
Representative name:
Date:
Call reference number:
*If your insurance company says that Nutritional Counseling is a benefit document: the date, and every detail of information from the call. Then we can verify that you will be covered through our practice.