Superbill vs Billing Service: Which Fits Your Practice?
A superbill vs billing service choice comes down to who files the claim. With a superbill, your client submits it and waits for reimbursement. With a billing service, a team files the claim for you. Here is how the two compare, and when each one fits.
What is a superbill?
A superbill is an itemized receipt. It lists your details, the client’s details, the diagnosis code, the service code and the fee. The client sends it to their insurer for reimbursement. Use our therapy superbill template and the glossary entry for superbill.
What does a billing service do instead?
In the superbill vs billing service choice, a billing service submits the claim to the payer on your behalf, tracks it, posts the payment and follows up on denials. Read what a billing service includes.
Superbill vs billing service, side by side
| Question | Superbill | Billing service |
|---|---|---|
| Who files the claim? | The client | The billing team |
| Who waits for the payer? | The client | You and your billing team |
| Who fixes errors? | The client, with your help | The billing team |
| Best fit | Out-of-network, private-pay practices | Practices that bill insurance |
Private payers vs Medicare vs Medicaid
Private payers may reimburse out-of-network care if the plan has those benefits. Medicare (see CMS.gov) and Medicaid generally require enrolled providers to bill the program, so a superbill is not the usual path. Medicaid rules vary by state. See in-network vs out-of-network credentialing and Medicare behavioral health billing.
What clients need to know about superbills
Clients who use a superbill usually pay you first and then ask their insurer to reimburse them. Tell them that reimbursement is not guaranteed. It depends on out-of-network benefits, deductibles and the plan’s own rules. Give them a clear, complete superbill and explain how to submit it. A complete form reduces back-and-forth for everyone.
Superbill vs billing service: which one should you start with?
If you take no insurance, a superbill may be all you need. If you accept insurance, a billing service saves the most time. Some practices use both, one for private-pay clients and one for insured clients. Whatever you choose, keep the records the same: the date, the service code, the diagnosis and the fee. Clean records make either path easier.
Key takeaways
In a superbill vs billing service decision, pick the path that matches how your clients pay. A superbill suits private-pay and out-of-network care when clients are happy to file on their own. A billing service suits practices that bill insurance and want one team to handle claims, posting and follow-up. Review your choice each year, because caseloads and payer mixes change.
Set expectations with clients
Whichever route you choose, tell clients early how billing works. State your fee, your payment policy and whether you will file claims. Put it in your intake paperwork. Clear expectations cut down on surprise bills and confused clients, and they give your billing process a stronger start.
When a billing service is the better fit
- You are in-network with several payers.
- You want claims filed for out-of-network clients too. MCM South bills out-of-network claims for clients.
- Clients struggle with paperwork.
- You want fewer unpaid balances.
Learn more in outsourcing therapy billing and how therapists pay their billing service. See our services.
Frequently asked questions
Can I use both a superbill and a billing service?
Yes. Some practices give superbills to private-pay clients and bill insurance for others.
What must a superbill include?
Provider and client details, dates, codes, fees and payment. See our template.
Will insurance always reimburse a superbill?
No. It depends on the plan’s out-of-network benefits.
Is a superbill the same as a claim?
No. A claim goes from the provider to the payer on a standard form such as the CMS-1500.
Where MCM South Medical Billing Service Works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.
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