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Physical Therapy

Physical Therapy

  • Zak Bartley

The Ultimate Physical Therapy Superbill Template

When do I use a superbill? Do all patients get a superbill? What goes on the superbill? What exactly makes this bill so super? We’ll answer all these questions below. If you prefer to skip ahead, download the physical therapy superbill template here.


Superbills are an essential tool for healthcare providers. Particularly, physical therapist use the superbill as an important business process. The Physical Therapy superbill template summarizes the charges and services provided to patients. The superbill does not include the narrative associated with the clinical note. Like a receipt, patients can submit to their insurance companies for reimbursement. In this blog post we will...


1. Explore the importance of superbills in physical therapy.

2. Provide an overview of the physical therapy superbill template.

3. Offer best practices to use the physical therapy superbill template.


Understanding the Physical Therapy Superbill Template


Patients use the Physical Therapy Superbill to seek reimbursement from their insurance provider. Patients can submit a claim for reimbursement using the provided superbill. The insurance company uses the codes and charges listed to process the claim. This information will determine the eligible amount reimbursed to the patient. Superbills are standardized in order for insurance companies to process claims faster.


The main purpose of the superbill is to provide a “proof of treatment” to the patient. The patient can submit this superbill to their insurance provider seeking reimbursement. How much will the patient be reimbursed? Reimbursement depends on several factors. This includes; the patient's insurance coverage, deductible, and in-network vs out-of-network benefits.


Pro Tip: You can help the patient understand their benefits by using PatientStudio’s Eligibility and Benefits Checker.


The key sections and fields of the Physical Therapy superbill template include:

  • Patient information

  • Diagnosis code(s)

  • CPT code (and description)

  • Date of service

  • Charges and units,

  • Provider information and signature.


Patient information includes the patient's name, address, and contact information.


Example:

[PATIENT NAME]

[PATIENT PHONE]

[PATIENT EMAIL]

Reason for Visit: PT Assessment

Was treatment needed as a result of a work-related injury or auto accident?


The procedure code & description field is used to document the specific physical therapy services provided to the patient.


Example:

Description

Procedure/CPT Code(s)

Amount

PT Eval: Low Complexity

97161

$150.00

Manual Therapy X 2 Units

97140

$70.00



When to use the Physical Therapy Superbill Template


Superbill for Out-of-network

If the practice is an out-of-network provider patients are commonly provided a superbill. Out-of-network (OON) means the practice is not contracted with the insurance company. Thus, there is no negotiated allowable reimbursement rate. The practice will charge the patient for the services provided. Then issue the patient a superbill. The patient can use the physical therapy superbill to file an out-of-network claim with their insurance company.


If the patient has out-of-network benefits this amount will go towards their deductible. After meeting the patient's deductible they will be reimbursed based on the UCR (usual, customary, and reasonable) rate.


Superbill for Denial?

In case of a claim denial, it is commonplace to shift the financial responsibility to the patient. Note: This assumes you have a financial policy in place that your patient has signed off on. Transfer fees to the patient’s responsibility. Then provide a physical therapy superbill to the patient. This will allow the patient to pursue reimbursement from their insurance provider.


Pro Tip: Get more patients to sign your financial responsibility policy. Use PatientStudio Online Patient forms to ensure your patients are consenting.


Superbill all of the time?

There's nothing wrong with giving a superbill after every appointment. A physical therapy superbill is essentially a receipt. This empowers your patient to seek out reimbursement. The only drawback is the time it takes you or your staff to use the physical therapy superbill template.



Best Practices for Physical Therapy Superbills


When it comes to billing insurance companies for reimbursement, compliance with billing regulations is essential. Physical therapists and billers should be familiar with the billing regulations and guidelines that apply to their region and payers.


What about cash rates and discounts? Can you still provide a superbill? Yes, you can and you should. The physical therapy superbill must reflect the amount the patient paid. Be sure to include a discount or “write off” line to reflect the proper patient paid amount. Similar to a receipt, all “line items” must be included


Can I put many visits on a superbill? Yes. Less commonly done, you can create and provide a superbill with multiple dates of service (DOS). In fact, if you requested a superbill following a hospital visit it will be detailed by DOS.


Conclusion


The Physical Therapy superbill template is an essential tool for physical therapists. The superbill allows PTs and OTs to document services they provide to patients. Patients are able to bill insurance companies for reimbursement. The physical therapy superbill template will help maximize new patients and business revenue.


Here’s what to do!


  1. Download the template.

  2. Customize the template with your and your clinic’s information.

  3. Detail the services rendered for each patient (adding additional rows if needed).

  4. Collect the patient’s payment.

  5. Give the superbill to the patient so they can submit it to their insurance for reimbursement.



“The superbill template is great because it helps therapists get paid (in cash) to still see patients who have insurance. They don't have to do a lot of extra paperwork. If patients want to be reimbursed from their insurance, they can give the insurance company the superbill.”



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