A superbill is a statement for insurance reimbursement. You give it to a client who paid you directly, for example because you are out of network with their plan, so they can claim the money back from their own insurer. It lists your practice and provider details, the client’s policy, the diagnoses and the coded services. In this article, you will learn what is on a superbill and the three places you can download one.
NOTE: Insurance billing is currently available for practices in the United States. A superbill is not sent to anyone. Downloading one does not change the invoice or the claim.
Option 1: From an Insurance Claim
Use this when the invoice is billed to an insurer and you want the statement to match the claim. Open the claim from More → Claims. Then:
- Click Export at the top of the claim.
- Click Download superbill. It is also in the claim’s ⋮ menu.
Download superbill from the claim’s Export menu
The superbill opens in a new tab. Click Print / Save as PDF and choose Save as PDF as the printer to save it, or print it on paper.
TIP: The superbill uses the claim’s current details, so check the claim first. For example, if First date of service (box 24A) is empty on the claim, the date of service is empty on the superbill too.
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What Is on the Superbill
A superbill with the practice details blurred
- Provider information: the rendering provider, place of service, the rendering and billing NPIs, Tax ID and taxonomy codes, and the referring provider when there is one.
- Client information: the client’s name, date of birth, address and account number.
- Policy information: the insurance company, insured’s name, member ID and group number.
- Diagnosis: each ICD-10 code with its description.
- Services: the date of service, billing code, modifiers, description, diagnosis pointer, fee, units and total for each line.
- Summary: total charges, any adjustments, the amount paid and the balance due.
- Signatures: the client’s signature when they have signed a consent form on file, and the provider’s signature or “Signature on file”.
Your practice’s name, address, phone and logo appear at the top, with the invoice number and date of issue.
Option 2: From an Invoice
Use this for a client who paid you themselves and has no claim in Pabau. Open the invoice from the client’s Financials tab. Then:
- Click Options.
- Click Download superbill to include every item on the invoice.
- Or click Superbill (Custom) to choose the items to show. Tick the items (or Select all), then click Print, or click Email to write to the client with the superbill attached.
Download superbill and Superbill (Custom) in the invoice’s Options menu
IMPORTANT: A superbill is built from the appointment the services were delivered at. If you see Link an appointment first, click Link appointment to link the visit to the invoice, then download the superbill again. If the invoice has no diagnosis, Pabau asks you to add one first.
Your practice’s NPI and Tax ID come from your Claim.MD billing profile. If you have not set one up, the superbill leaves those lines out.
Option 3: Several Invoices at Once
For a client with a run of visits under one insurance case, open the client’s Insurance tab and click View on the case. Under Invoices, tick the invoices you need, then click Export ▾ and choose Batch superbill.
Superbills, Claims and CMS-1500 Forms
| Document | Who sends it |
|---|---|
| Superbill | The client sends it to their own insurer to be paid back. |
| Electronic claim | Your practice sends it to the payer through Claim.MD, and the payer pays you. |
| Printed CMS-1500 | Your practice mails it to a payer that takes paper claims. Use Print CMS-1500 form in the same Export menu. |
What's next?
- Exporting and submitting CMS1500 claims manually
- How to set rendering and billing provider details for each practitioner
- Insurance billing glossary
- Insurance Guide Part 4: Submit and track insurance claims in Pabau
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