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Superbills for covered services in a Non-participating FFS practice

  1. Default Superbills for covered services in a Non-participating FFS practice
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    I work for a non-participating fee for service physician and we used to provide Superbills to submit to their insurance for potential reimbursement. Now they've stated they do not have to provide anything but an itemized receipt to submit to their FSA/HSA. Is this correct? I do not believe they can avoid giving a Superbill with appropriate CPT and ICD-10 codes, but they feel otherwise.
    If someone has any information and resources to support such information it would be greatly appreciated!

    I myself see a chiro who doesn't take insurance and I would be upset if I didn't have something to turn in at least for a co-pay amount.

    Thanks in advance for your time!

    K.Lefebvre, CPC

  2. Default
    The patient's I have ask have all asked for a receipt/statement and their HSA's have paid each time.
    Wage works only requires a detailed receipt to pay. This is what their website says:

    An itemized receipt is a receipt that contains the following five pieces of information:

    Patient's Name: The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
    Provider's Name: The provider that delivered the service or where the item was purchased.
    Date of Service: The date when services were provided or the item was purchased.
    Type of Service: A detailed description of the service provided or item purchased. A bag tag is sufficient for prescriptions.
    Cost: The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.

    We may ask you for an itemized receipt in order to verify that your transaction was for an eligible expense per IRS guidelines.

  3. Default Thank you
    Thank you, but our clientele usually request something they can turn into their insurance for reimbursement especially if they do not have an HSA or FSA.

  4. #4
    If patient has out of network benefits Insurance is going to want itemized receipt with CPT codes and cost. They may want ICD as well as Provider details such as NPI and TIN.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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