The Superbill vs. the Receipt: What’s the Difference?

You’ve probably heard the terms Superbill and receipt before, but do you know what the difference between them are? If you’re not sure, this article will help you find out.

What is a Superbill?
A Superbill, also known as a charge summary, is a streamlined version of an invoice that outlines all charges for a specific service or visit to your doctor’s office. A Superbill includes everything you would expect to see on an invoice, including payment information, charges and description of services performed and tests ordered. A Superbill is only provided when you are not a ‘cash pay only’ client (i.e., asserting that you are not seeking reimbursement from your insurance company) and when insurance is not filed by your provider. If your insurance is filed directly by the provider you will receive statements but these may be largely incomplete until your insurance responds to the claims submitted. Please note that insurance companies may take 45 days to several months to fully respond to your provider about what they will and will not cover. They often provide providers and their clients with estimates of what they may cover – that they cannot be held to fulfilling.

Things you need to know about a Superbill.
If you receive a Superbill from your provider, it is your job to file this with your insurance. You should expect that your insurance may provide feedback and often attempt not to pay your benefits. This is, after all, how insurance companies stay in business and maintain more money than they issue out. Be prepared to discuss with your insurance how the services should be covered by your benefits and don’t be dismayed by quick answers from customer service representatives that your provider may have “coded something wrong” as that is usually a “safe” answer for the customer service representative rather than stating “this service may not be covered by your plan.” As always, it is your responsibility ultimately to understand your healthcare plan coverage. Communications between insurance companies to providers are often not reliable until payment or an EOB (Explanation of Benefits) is provided following services and their determination of your plan’s coverage of those services.

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