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Billing formats for clients for Supervision

what's up guys when I first started in private practice I had never even heard of a super bill or out-of-network billing but it turns out that super bills are incredibly useful in private practice and they're also super simple to use in this video I tell you everything you need to know about super bill so you're all set up for out-of-network billing [Music] welcome to private practice skills I'm dr. Marie Fang psychologist in private practice I post videos offering tools I learned the hard way about starting and growing private practice so that you don't have to so what is a super bill a super bill is a detailed itemized receipt used by health care providers like us to reflect the services that we offer most often super bills are used for reimbursement to some type of third party payer like insurance now if you're familiar with billing insurance then you might be wondering what's the difference between a super bill and a CMS 1500 form good question but before we get into it let me explain what a CMS 1500 form is for those of you who are not familiar the CMS 1500 is a form used by healthcare providers to build directly to insurance for reimbursement for the most part the CMS 1500 form only applies to providers who are in network on insurance panels to really understand what I'm saying I think I really need to break down the difference between in-network providers and out-of-network providers in network providers have negotiated a contracted rate with insurance companies for the services that they provide so for example if let's say you're in network with a Blue Cross Blue Shield Blue Cross will predetermine what rates they pay you at usually they decide what market rate is which is usually a little bit below actual market rate and then they pay you a fraction of that amount for reimbursement this is a pre negotiated price that they pay you for your services when you see an in-network member in contrast out of network providers do not enter a contract with insurance companies but some insurance policies will offer an option for their members to see a provider who's out of network and then they'll reimburse some portion of that rate to their member so here's how the billing process differs between whether you're an in-network provider or an out-of-network provider when you're in network on an insurance panel you complete the CMS 1500 form submit it directly to insurance and then they must approve that claim before they go ahead and send you payment for the services you offered to their member when you're an out of network provider your client pays you directly out-of-pocket for your services and then from there it's up to them to negotiate with their insurance policy whether they receive any reimbursement for that service this is where the super bill comes front and center personally I'm not currently in network with any insurance providers if you're curious about my experience being in network with insurance I'll link to a video up here or in the description box and you can hear all about my experience so basically when you're providing out of network services the super bill is your clients ticket for receiving some reimbursement for that service of course to avoid any potential insurance fraud insurance companies do require a fair amount of information on this super bill just to make sure that you are who you say you are and that you are providing the services to this client here are the key items that were required to include on the super bill receipt your basic information as the provider such as your name address and phone number your professional information such as your tax ID number NPI number and license number you need to provide some identifying information about your clients such as their name icd-10 diagnosis code and their birth date and finally of course an itemized list of services that your client has paid you for including date of service CPT code description of service and how much you charge for that service in addition to these requirements I found it helpful to include a couple of additional items such as the place of service code as well as a clear statement at the bottom signifying that the client has already paid me in full for these services and this is not a bill and lastly I do like to sign and date this super bill just for good measure to make clear that it's me writing this super bill and that's all there is to it once you get into the swing of things with super bills it really only takes like a minute and a half to complete per client and I usually fill them out once every several sessions so this is a really low cost on our part in order to offer a great benefit to our clients once you've handed the super bill to your client it's up to them to coordinate with their insurance provider for any reimbursements they might qualify for so that means once you've handed the super bill to your client you're all done that's it it takes like 90 seconds and it's really easy I found over time that often clients may not be aware that they qualify for these out of network benefits with their insurance policy so I've made it part of my initial phone screen practice to let clients know that it is an option to bill out of network and many times clients have been surprised to follow up with their insurance and realize that some or most of their therapy is covered by out of network coverage it's really wonderful so as you can see super bills are a great way to make therapy more accessible and affordable to your potential clients well you're still insured to receive your full fee it is absolutely worth considering adding super bills as a potential resource to your clients to help your practice and offer that service to the community there's no official formatting for what your super bill receipt needs to look like and everyone kind of has their own stuff or how they format theirs if you'd like to reference my super bill receipt as a template you're more than welcome to find the link in the description box to snag it for free and make it your own well I hope you found this video about super bills helpful and until next time from one therapist to another I wish you well but if you change your mind you can just interrupt at any point