- Your name
- Your address and phone
- Any additional indetifying information (like your social security number)
- Your doctor's name
- Your doctor's address
- Your doctor's license number, NPI number, tax ID number
- Your diagnosis
- The treatment(s) rendered to you
- The cost of the treatment
- The amount you paid
- A release authorization statement
- Your signature
- Your doctor's signature
Once you receive your superbill, check it for accuracy (make sure the dates/times of your visit and the amounts you paid are correct). Then simply submit the document to your insurance company for reimbursement. Your insurance company MAY reimburse you depending on the level of coverage you have. Prior to starting work with a clinician who uses superbills, you should contact your insurance company and say, "I want to work with an out-of-network provider, how much will you reimburse me?" The only way to know for sure what your insurance company will pay is to ask them directly, or better yet, get it in writing via fax or email.
Be aware that should you choose to submit a superbill, you are releasing medical information that is protected by law. This means you are waiving some of your rights to provacy and confidentiality. Your insurance company will have and keep a record of your diagnosis as part of your permanent medical file. These files can be used by insurance companies to set your rates and to allow or disallow further treatment.