Superbill seems appears to be a huge scary term that most of the people may be unaware of. All of us face these super bills one way or the other because all of us need to go to the hospital for some reason.
To begin with the description of a typical superbill, we need to know what exactly a superbill is. A superbill if defined literally means a list of physician charges generated by a hospital. Superbills are used by the healthcare providers working in a clinic or a hospital. It is used as a source of data and information on the basis of which all the charges and claims are mentioned at the time of discharge of the patient. These bills are used as the claims for the payers for reimbursement.
What are the components of a super bill?
Medical superbills consist of all the details of the physician’s visits, examinations and the procedures done on the patient. Let’s have a detailed look at the medical super bills components.
- Name and contact details of the patient are written in the topmost portion of the medical superbills. This section also includes the patient’s ID issued by the hospital where he is seeking medical services. Age, sex and date of birth are among the mandatory details about the patients.
- Name and contact details of the provider are mentioned at the beginning of the medical superbills. This information also includes the information of the insurance companies which pay for the health care expenses of the policyholders.
- In the next section of the medical superbills, the evaluation of the patient is done on the basis of codes and overall charges is verified and claimed on the basis of these codes again. These codes are different for the patients who come for the first time and for the patients who have come for a follow-up visit.
- Similarly, the codes for the lab investigations are also designated and these codes are then evaluated for overall reimbursement of the medical bills. Different codes are assigned for different types of lab procedures for example gram staining, stool culture, cholesterol screening, urine analysis, HIV investigations, and many others.
- In the same manner, codes are assigned for all the procedures done in the hospital regardless of the fact that these are performed as day care procedures or inpatient procedures.
- Separate bills and codes are formed if the patient has received any form of counseling. Duration of counseling also affects the overall bills of the patient.
- If the patient is prescribed some sort of medication, the codes for that medication have also been included in the medical superbills. Codes for antibiotics and each of their class is different. Similarly, codes are assigned for anti-hypertensive drugs, anti-diabetic and other drugs.
- Some more codes have been given for special situations for example in case of complication of a procedure or prolonged hospital stay than normal.