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Electronic superbill

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Title: Electronic superbill  
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Electronic superbill

For the counterfeit U.S. currency, see Superdollar.

Superbill is itemized form utilized by healthcare providers for reflecting rendered services. Superbill is the main data source for creation of healthcare claim, which will be submitted to payers (insurances, funds, programs) for reimbursement. Although the superbill form is not unified, and it is created/modified depending on healthcare provider specialty, type of rendered services, additional requirements, as well as ease of handling, there is a set of obligatory attributes, relevant to all superbill types.

Superbill form consists of 4 main parts, containing mandatory fields to be completed for accurate claim creation:

Provider Information

Walter R. Pangalangan 205 Meadow Street Walterboro, SC 29488

Ordering/referring/attending physician

Pangalangan, Walter, MSPT 1720020183

Patient Information

Ruby Stephens 07/12/1947 Care Improvements ID# 100134788

Visit information

  • Date of service
  • Procedure codes (CPT) – list of commonly used codes by medical provider according to the provider specialty
  • Diagnosis codes (ICD-9) – list of commonly used codes by medical provider according to the provider specialty
  • Modifiers (Location and conditions modifiers)
  • Time (for timed codes)
  • Units
  • Quantity for drugs
  • Authorization information (if applicable)

Additional information

  • Notes and comments (for e.g.: PT cap)

Superbill utilization rules

  1. Each superbill must be signed by rendering provider of service. Superbill without a signature cannot be processed by medical biller. By signing the document the healthcare provider is acknowledging the services rendered and confirming that information on superbill is permitted to be sent to insurance company by medical biller.
  2. All required fields should be completed (with the exception of those that are considered optional)
  3. Provided information should be readable
  4. CPT and ICD-9 (ICD-10 -Starting October 1, 2014) codes should be marked clearly
  5. In case if required CPT or ICD-9 code could not be found in the given list, Provider should give legible handwritten description of service/diagnosis, along with additional information (units, time, type, etc.)
  6. Only generally accepted medical terminology and abbreviations are allowed

Further reading

  • The Superbill-Guide to a Uniform Billing and-Or Claims System(IsBN 0685033295)by Medical Group Management Association Staff, Costello, William E.

External links

  • [1], American Medical Billing Association
  • [2], WCH Billing Bureau
  • [3], American Academy of Professional Coders
  • [4], American Health Information Management Association
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