Superbills: How do they work?

Guide to Using Superbills for Insurance Reimbursement in Speech Language Pathology

A common question we get is, “is speech therapy covered by insurance?”. At Hart Therapy Services, we do not accept insurance, but provide superbills for families who choose to seek reimbursement for speech therapy services from their insurance company. This guide is designed to assist you in navigating the process of submitting superbills for reimbursement.

Step 1: Confirm Coverage for your Insurance Plan:

Before proceeding, check with your insurance provider to confirm whether speech and language therapy services are covered under your plan. Obtain information about reimbursement rates, deductible amounts, and any other relevant details. The best way to do this is to call your insurance using the number for Member Services, typically listed on the back of your card.

You will want to ask your insurance company about out-of-network provider benefits, where to submit your superbill, and how reimbursements are distributed. Some common questions might be to about specific disorders that qualify for speech therapy, restrictions on CPT code 92507, restrictions on number of sessions, and information about co-pay or deductibles for out-of-network reimbursements.

Step 2: Review & Download your Superbill:

At Hart Therapy Services, superbills are sent through our client portal on the first of the month for all services paid for in the previous month. If you prefer to change the frequency of superbills, please reach out to your speech therapist. Review the information to ensure it aligns with your sessions that month. A superbill is a detailed invoice that includes the necessary information for insurance reimbursement. It typically contains the following details:

- Provider information (name, address, NPI, tax ID), Patient information (name, date of birth, address), Date of service, Description of services provided, CPT (Current Procedural Terminology) codes for each service, Diagnosis codes (ICD-10 codes)

Step 4: Submit the Superbill to Your Insurance Provider:

Submit the superbill to your insurance provider for reimbursement. This can usually be done through the following methods:

- Online portal submission

- Mailing the superbill along with a claim form

- Uploading documents through a mobile app

Step 5: Follow Up with Your Insurance Provider:

After submission, follow up with your insurance provider to track the progress of your reimbursement claim. Check the status of the claim and inquire about any additional information or documentation required. Let us know if there is any additional information needed from us. You may need to reach back out to member services to familiarize yourself with reimbursement policies, including any limitations, exclusions, or requirements.

Note:

- Not all insurance plans provide coverage for out-of-network speech-language pathology services.

- The reimbursement process may vary between insurance providers, so be sure to follow the specific guidelines outlined by your insurance plan.

If you have any questions or need further assistance, please don't hesitate to reach out to us at Hart Therapy Services. We're here to support you on your journey to accessing quality speech-language pathology services.