Reducing the Cost of Therapy: How to Submit a Superbill to Insurance
A Guide and Answers to FAQ about submitting Superbills for Reimbursement
When clients begin therapy with me, I ask if they would like a Superbill (detailed receipt) that they can submit to their insurance for reimbursement. Some people say, “yes, please!”, others say, “no thanks”, and many others look confused and ask me, “what is that?” When I explain, I think some people still don’t submit the Superbill because, well, they really don’t know how to do so, and it feels to confusing to try. They figure that they must either pay my full fee or wait to find an in-network therapist.
While I do require payment in full at the time of service, there is another way to see me and try to reduce costs. That is by submitting a Superbill.
Why do this?
As you know, I am a private pay practitioner. I am not panelled with any insurance companies; in other words, I am not “in-network” with your insurance plan. This means that clients pay me my full fee directly. But one way to reduce the cost of working with me is to submit a Superbill (a “detailed receipt” of out-of-network services) to your insurance. ( For more information on what all of this is, please see https://www.openbridgescounseling.com/resources.)
I can give you a Superbill for you to submit to your insurance. Depending on your particular insurance plan, they may then reimburse you for at least part of what you paid me. So, for example, you pay me $160 for a session. I give you a Superbill, and you submit it to your insurance. They then reimburse you for a certain amount - let’s say, $70. So the total amount that you paid me was $90, which is considerably less than my hourly fee. (This is a hypothetical example! The actual amount they reimburse is something that they determine.) The point is, when you factor in the money you get reimbursed by insurance, you end up getting something back of what you paid me.
So, while it may seem like a hassle, once you get the hang of it, it may be worth it to you to try submitting a Superbill for the cost savings.
How do I do this?
The best way is to submit the Superbill to your insurance is to do it through the document portal on your insurance’s website. It’s important to note that each insurance may have their own preferred way for you to submit this Superbill, either by fax, by email/electronically, or by postal service/”snail mail”. It is important to follow the directions on where/how to send the Superbill, along with any other documents they want you to submit.
Do I have to do this?
No, submitting a Superbill is completely optional. For various reasons, people may elect not to do this. However, if you choose not to, you won’t get any reimbursement for what you paid me for my services. Also, if you don’t do this and you later decide to, reimbursement may be delayed or denied for reasons that are beyond my control.
Please note that if you are a Medicare recipient, per their rules, you cannot seek reimbursement from them. Their rules are a bit stricter than private insurance, in that they will not reimburse services for a provider who has “opted out” of being a Medicare provider. Per their requirements, I also have clients sign an Affidavit stating that they will not seek reimbursement from them. At the time of this writing, this is the case. So, at the time of this writing, please do not try to submit a Superbill to Medicare for reimbursement of services with me!
How much will insurance reimburse me for what I paid you?
Short answer: I don’t know. This depends on your particular plan: Whether or not you have out-of-network benefits, how much this plan reimburses you for out-of-network benefits, and what type of session they reimburse.
If you do an extended session with me, please know that at the time of this writing, most insurance plans will not reimburse you for them. You can still try submitting the Superbill I give you and see if they will at least pay for part of the session.
Things to know:
If you do submit a Superbill, your insurance may claim the right to audit your records with me, including any diagnoses, treatment notes, etc. It doesn’t always happen, but it may. Just something to be aware of.
Medicare recipients cannot submit a Superbill to Medicare for reimbursement for services with me (see above).
How long does it take?
For many insurances, you should get a response and/or a reimbursement payment within two to four weeks of submitting the Superbill. Before this, you likely will receive an EOB (Explanation of Benefits) that shows how much, if any, you will get reimbursed for sessions. Oftentimes, you can access the EOB from your provider portal under the “Claims” section.
Helpful hints:
Please submit the Superbill as soon as you are able. The sooner you do so, the more likely you will get reimbursed, assuming your plan allows for this.
Make sure you are submitting the Superbill per your insurance’s instructions, and that you have the correct address/number, and any documents they request. If they wish for you to direct the Superbill to a particular person or department, make sure you include that, too.
If you do submit a Superbill, your insurance may claim the right to audit your records with me, including any diagnoses, treatment notes, etc. It doesn’t always happen, but it may.
Hopefully this clarifies the process and purpose of submitting Superbills. You don’t need to fear the process, and in most cases, it is worth trying.
Best of luck!