The SuperbillDesk magazine
Billing craft, benefits rules and practice economics for out of network therapists who set their own fees and keep their own books.
Nine working pieces, updated as payer rules move. Every one of them is written for a clinician who sets a fee, hands over a statement and then wants the reimbursement question answered without a billing service on retainer.
practical guide
A superbill is not an invoice and not a claim. Here is every field a payer expects to see on one, where each number comes from in your chart, and how to hand it to a client safely.
comparison
Three codes cover most of a private practice week, and the difference between them is time, participants and documentation. A side by side look at what each one requires of you.
mistakes to avoid
Most out of network denials trace back to a handful of fixable fields. These are the eight that send clients back to you asking for a corrected document, and how to stop making them.
regulation and compliance
The No Surprises Act put a written estimate requirement on every self pay client you see. What has to be in it, when it has to be delivered, and how recurring weekly therapy is handled.
case study
Follow a single fifty minute session through documentation, a month end superbill, a client submission, adjudication and an explanation of benefits, all the way to money in a client's account.
trends and outlook
Federal mental health parity law now reaches into how plans build networks and pay for care outside them. What the rules cover, what they do not, and what that means for a cash pay practice.
checklist
A repeatable close for the last day of the month: reconcile the calendar, check every code against the chart, match payments to charges, send the superbills and file your copies.
numbers and benchmarks
Allowed amount, deductible, coinsurance and balance billing decide what a client actually recovers. Work the arithmetic step by step so you can answer the question before the first session.
field report
What actually happens when you phone a payer to check a client's out of network coverage: the menu maze, the questions that matter, the reference number, and the limits of what a rep can promise.
