A psychiatry superbill is one of those terms that every mental health provider knows, but does not enjoy talking about. It seems to be a pretty common feeling among providers in the industry that billing is one of the most frustrating and inconvenient parts of being a therapist. While it may be annoying, billing is how a therapist earns their income, keeps their doors open, and continues being able to help clients in need. Understanding the inner workings of therapy billing and how to do it effectively is what enables a therapist to keep doing the parts of their job that they love. So what is a psychiatry superbill and how does it work?
What is a Psychiatry Superbill?
Different from a claim, an invoice, or a receipt, a psychiatry superbill is the document that is comprised of all the information insurance companies need to make a payment decision. This definitely sounds a lot like an insurance claim, but there are some key differences. An insurance claim is billed by the therapist directly to the client’s insurance and a superbill is not.
The main difference between a regular insurance claim and a psychiatry superbill is that the superbill is for the client and does not go directly to a payer. This is because your mental health organization either does not work with insurance, a client has out-of-network coverage, or your practice has yet to join the provider panel for that particular payer. The psychiatry superbill details all information a payer needs to make a decision about reimbursement but is given to the client directly, not the payer. The client then takes the document and uses it to work directly with their payer to determine reimbursement.
Why Use a Psychiatry Superbill?
There are many different reasons why a provider would choose to work with psychiatry superbills rather than bill insurance claims. While the quickest way to get paid is to get onto an insurer’s provider panel, this is not always an easy process. It can take time. A psychiatry superbill enables providers to get started seeing clients immediately rather than having to wait for insurer cooperation.
The issue with this is that care is not as accessible to clients who are looking for a provider with insurance. The benefit of a superbill is that it lets you accept a client’s insurance without being on their provider panel. The client is responsible for taking the superbill to their insurance provider and working out reimbursement rather than you.
This is the best option for providers who are waiting to get approved for an insurer’s provider panel.
What a Psychiatry Superbill should include:
Similar to an insurance claim, there are specific pieces of information that are required to be on a psychiatry superbill. Failure to include all of the relevant information could make it difficult for your client to be reimbursed. Superbills should include the information as follows:
Client Identifying Information
Provider Name/Credentials
Office Address
Office Phone Number
Tax ID
NPI
Dates of Service
Applicable CPT code
Fee of Service
How do Payments Work?
While a psychiatry superbill allows a provider to accept all insurance types, payments work differently than if a provider were to bill the insurance provider directly. When a provider files an insurance claim with a payer, the payer reimburses the provider directly.
This is different from a superbill. When a provider uses superbills, the client pays for the services, in full, at the time of the visit. The client then takes the superbill to their insurance provider and works out reimbursement for what they paid you.
Many clients are deterred by this process because they do not like the idea of having to pay for services in full. They would rather go through their insurance company to determine their upfront, out-of-pocket costs. This is something to consider when determining which direction you want to go. While you receive your payment at the time of services, your client might feel uneasy about that process.
Superbill Tools
Creating psychiatry superbills can be extremely time-consuming. While many therapists have digital tools that help them quickly create and file insurance claims, they still have to create superbills by hand. It is important to find tools that help you quickly create superbills in order to streamline your workflow and avoid spending too much time on billing.
To learn more about tools that can help your organization easily create and distribute psychiatry superbills, click here.