Superbill Template

For those practices without superbill automation software or those who complete Superbills manually, this Superbill template can help ensure you include all the necessary information and reduce the chances of insurance claim rejections.

By RJ Gumban on Jul 15, 2024.


Fact Checked by Nate Lacson.

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Superbill Template PDF Example
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What Is A Superbill Template?

A superbill is a comprehensive, itemized list of services sent from a healthcare provider to a payer, such as an insurance company, for reimbursement. The superbill is the primary source of information for a patient’s healthcare claim, and as such, it is crucial to include all necessary details in order to prevent the rejection of your patient’s insurance claim.

While many healthcare practices choose to use software to automate their superbill creation process, for those that can’t or choose not to automate this process, our  can help facilitate this process. The medical billing process can be difficult to wrap your head around, so before we continue, feel free to take a look at Carepatron’s Ultimate Guide to Patient Billing to refresh your memory on how this whole process works. But, if you’re feeling ready to start creating your own Superbills, then just read on!

How To Use This Template For Superbill

This template can be used to create an itemized list of the services your patient received. As this Superbill is the primary information source for your patient’s medical insurance claim, it’s very important that the information it contains is accurate and meets the information requirements of the insurance company or payer. To help prevent your client’s claim from being rejected, just follow these steps.

Step One. Provider, Patient, and Insurance Information

Fill out each of these sections with the relevant information, being sure to include the Provider NPI, Patient Date of Birth and address, and your patient’s insurance details.

Step Two. Procedures

The Procedure Information section is for the list of procedures your patient received from your practice. For the sorts of procedures included in this section, take a look at the most commonly used CPT codes. Ensure you add the relevant CPT code for the procedure, any modifier, as well as the units, fees, and payment information.

Step Three. Diagnoses

Similarly to procedures, diagnoses must also be accompanied by a code- however, these will require an ICD-10 code. It’s important to be clear on the difference between ICD and CPT codes, as errors in medical coding can result in rejected claims.

Step Four. Payment Totals

To make the total payment due crystal clear, we have included space for the Total Charges, Total Paid, and Total Due at the bottom of the Superbill template. You can calculate these figures using the Fees, Amount Paid, and Amound Due columns in the Procedure Information section.

Step Five. Sign the Superbill and Store a Copy Securely

The final step is for the provider to sign the Superbill, return a copy to either the patient or directly to the insurance company, and store a copy securely for record-keeping purposes.

Who Can Use this Printable Superbill Template (PDF)?

We have kept this Superbill template general enough to be used by any healthcare provider. This could be therapist practices, family doctor clinics, hospitals, or any other healthcare provider. While many of these providers will utilize software to automatically generate their superbills, greatly reducing chances of errors, this Superbill template is aimed at those who do not have this capability at their practice.

These providers may include:

  1. Mental Health Counselors
  2. Hospices
  3. Nursing Homes
  4. Primary Care Clinics
  5. Sexual Health Clinics
  6. Occupational Therapists
  7. Nurse Practitioners

This is by no means an exhaustive list, and if you are unable to automate this process or choose to complete your superbills manually, then this template can help you.

Why Is This Form Useful For Healthcare Professionals

Standardize your Billing Process

Having a template for the superbill creation process is one of the core steps to ensuring your superbills are consistently accurate and detailed enough to ensure your clients’ claims are consistently accepted.

Improve Data Security

Having just one superbill template to keep track of each time you create superbills makes it easier to store this document safely and securely. This template contains confidential information on your client, and so it is important that you can store it securely. This template allows you to keep the superbill digital, meaning you can utilize digital encryption and protect your client’s information.

Save Time Formatting

Superbills contain a lot of information, and presenting all that information clearly can be a real task! Luckily, our superbill template takes all the formatting off your hands- meaning you just need to fill in the blanks.

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Benefits of Superbill Templates

Don’t Leave Anything Out

For superbills covering a number of procedures, it can be easy to forget to include a code or modifier, and suddenly your patient’s claim is rejected! Our template includes clearly laid out spaces for each piece of information, helping to ensure you include everything you need.

Reduce Chances of Rejected Claims

An additional benefit of the layout of this Superbill template is that by reducing the chances of human error, you also reduce the chances that your patient’s claim is rejected- saving time on the administration work required to re-submit a claim. 

Edit Digitally

Speaking of time-saving, this PDF Superbill template includes interactive text boxes allowing you to fill it out completely digitally. This means you can copy and paste relevant information into the Superbill, save time handwriting, and save paper!

Includes Space for CPT and ICD-10 Codes

Mixing up medical codes is a common cause of errors in Superbills, and so we have clearly laid out where the CPT and ICD-10 Codes go. Just one more step to help you reduce errors and assist your patients in getting their claims accepted! 

Clearly Display Payments Due and Paid

Finally, ensure your maths is correct with our clearly displayed sections for the Total Charges, the total amount paid, and the total due. By including these three numbers, you’ll ensure your maths is infallible and that the amount due is clearly displayed and calculatable.

What is a Superbill?
What is a Superbill?

Commonly asked questions

What is a Superbill?

A superbill is similar to an invoice, but represents the main source of information to create health claims for insurance companies. As such, the accuracy of the superbill is very important for preventing the rejection of insurance claims. The superbill includes diagnoses, services, fees, fees paid, provider information, client information, and the client’s insurance information.

When should I use a superbill?

A superbill should be created following the provision of any service to a client of your healthcare practice. Some insurance companies have requirements for superbills to be filed within a certain timeframe from the provision of the service, and so creating superbill in a timely manner is a good habit to get into. Many software platforms will automate the creation of superbills for you on a monthly basis.

Who uses Superbills?

Superbills can be used by any healthcare provider to facilitate reimbursement from a payer, such as an insurance company or fund, for their clients. The providers may be mental health clinics such as a therapist’s office, health clinics, hospitals, or any kind of healthcare practice.

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